Category Archives: health

Thinking about death

When is the last time you thought about your life ending? Did this cause distress or cheer you up? Either way, you’re thinking about your own mortality, and that can change the way you think and act on other issues. More on this later.

            When I was a teenager, I thought a fair bit about the end of my consciousness, and started reading about death. I don’t remember the names of any of the authors except for the Spanish writer Miguel de Unamuno, and don’t remember what any of them said!

            At Rice University in 1968, I had the opportunity to take a class titled “The meaning of death in Western culture.” I remember that I wrote my final essay arguing that religious arguments for immortality were inadequate and the best scientific evidence for life after death was from psychic phenomena, and this evidence was inconclusive. I was majoring in physics and I guess my scientific mindset was on display.

            In the following years, the issue of my own mortality became less salient. I still read and thought about death-related issues, for example through my studies of nuclear extinction, the euthanasia debate and Death imagined as a powerful perpetrator. Even so, I became far more accepting of the end of consciousness.

            What would it be like to go to sleep and not wake up? The best answer I discovered was in the book The Mind Club by Daniel M. Wegner and Kurt Gray. The authors say it’s intrinsically impossible to understand non-existence because there would be no “I” to think about it. As they put it, “Trying to perceive your dead mind is paradoxical, because you have to perceive a state that is incapable of perception — which is impossible while you are currently perceiving.”

Mortals

Recently, while in the Sydney bookshop Dymocks hunting for something to read, I saw Mortals: How the Fear of Death Shaped Human Society. Written by two psychologists based in Sydney, Rachel Menzies and Ross Menzies, it seemed a perfect opportunity to refresh and update my understanding of death issues.

            Menzies and Menzies begin by tackling a big issue: religion. They go through several of the world’s major religions, including Christianity, Islam, Hinduism and Buddhism — the four largest in terms of adherents — arguing that much of their appeal comes from their promise of immortality, in one form or another. And why should anyone seek immortality? The fear of death, of course. If major religions are successful in recruiting and retaining followers due to their role in reducing the fear of death, this is indeed a powerful influence on human society. In some religions, your immortality comes via your mind, but in Christianity your body is part of the package, which presumably is more appealing. Menzies and Menzies say less about a negative side of immortality: the possibility of everlasting damnation. Why would religion be attractive if it comes along with the risk of going to hell? Maybe this uses the fear of death in an even more potent combination: frighten people with visions of hell and then promise everlasting life in heaven if only they believe.

            But is fear of death the key driver of religious belief? Research shows that people who are religious are happier, on average, than those who are not. Religious belief plays a role in this, but so do social relationships, which are known to promote happiness, among believers. Some religions have rituals involving expressing gratitude, something that reliably improves happiness. So there might be more to the attractions of religion than just warding off the fear of death.

TMT

In the 1980s, three researchers — Jeff Greenberg, Sheldon Solomon and Tom Pyszczynski — developed what is called Terror Management Theory or TMT. Despite the name, this has nothing to do with terrorism. It is about people’s fear of death, a fear so great as to warrant the word “terror,” and posits that this terror, even when not recognised consciously, has major influences on thought and behaviour. When I first read about TMT, years ago, it sounded a bit crazy, but there’s lots of research showing the impact of being reminded about death.

            In a typical experiment, the participants — most commonly undergraduate psychology students — are brought into the lab and asked to undertake a task, like solving anagrams. The task is seldom the real purpose of the study but is designed to distract their attention, so they don’t realise what the experimenter is trying to find out. Along the way, some participants are exposed to an article or video with images of death, whereas others, the controls, are exposed to a “neutral” equivalent like a cat video. Then there is a further task, or something happens, and the participants are watched to find out what they do. In one study, they needed to wash their hands, and the experimenters cleverly weighed soap dispensers and counted paper hand towels before and after.

            With ingenious experiments, researchers have discovered all sorts of fascinating things about how people react to being reminded of death. One finding is that some people become more willing to punish those not in their own group, such as foreigners. But only some people are affected this way, mainly those with certain personality traits or political orientations. Still, the overall picture is worrying. According to Menzies and Menzies, “Hundreds of studies show that nearly any reminder of death makes people more aggressive, more racist and more willing to inflict harsh punishments.” (pp. 82-83)

Living forever in the flesh

What are your prospects for immortality in your own body, here on Earth? Back in the 1970s, one of my colleagues, Tom, planned to have his body frozen when he died so that, with future recovery techniques, he could later be restored to life. This process is called cryonics. Tom wasn’t alone. Thousands of people have signed up to have their bodies, or just their heads, frozen at ultra-low temperatures in the hope of being brought back to life when the technology is available.

            Tom was a peculiar guy, lacking typical social skills. This was not uncommon for pure mathematicians, but Tom was at an extreme end. I used to imagine some future group of scientists restoring frozen people from a previous century and saying, “This is amazing. Everyone back in the 1970s was a lunatic!” If Tom was an emissary from our time to the future, he was hardly typical. But at least he was a gentle, introspective soul, not a megalomaniac.

            Menzies and Menzies use cryonics as one of many examples of the human quest for immortality. Incidentally, they give many reasons why the prospects for resuscitating a frozen brain are minimal: those relying on cryonics to have their minds restored have let hope triumph over the evidence.

Living forever symbolically

Menzies and Menzies offer a new perspective on Michelangelo’s painting of the Sistine Chapel. Michelangelo insisted on making this artwork a fresco, so it is part of the surface, making it far more lasting than a wall painting. In their telling, Michelangelo was willing to spend years of agonising effort so his art would be long remembered. In this, he was successful. However, most artists are not. Before long, they are forgotten.

            Menzies and Menzies argue that striving for symbolic immortality is important in driving cultural production. I thought this could apply to me because I’ve written lots of articles and books. The quest for a type of immortality may play a role, but there are other factors. Artistic production is one way to enter into a state called flow in which one’s focus is entirely on what’s happening and the sense of self recedes from consciousness. The pioneer researcher on flow, Mihaly Csikszentmihalyi, found that this is a highly desirable mental state that can be entered through all sorts of means, typically exercising a skill at a level challenging enough to avoid boredom but not so challenging as to induce anxiety. Quite independently of the fear of death, entering flow can be a motivator for producing artistic works. On the other hand, is flow a way to avoid thinking about death?

            Menzies and Menzies discuss several other ways that people try to deal with their unconscious fear of death, for example taking vitamin supplements and exercising. In every case, there are other factors. For example, physical activity is the most reliable way for people to feel better physically and mentally, which surely is a worthy goal even for those unconcerned about dying.

            The authors make a grand claim: “We have shown that nationalistic fervour, aggression against outgroups, religious wars, popping vitamins, endless hours on treadmills, investing in cryonics and futile health interventions all arise from failing to accept one’s mortality.” (p. 181) I think they’re on solid ground with cryonics, but for the other topics more is involved, and the precise role of the fear of death remains to be determined.

            Mortals is filled with fascinating information from cultures around the world. How about this? In Alabama, you can have your ashes incorporated into a shotgun shell. In this way, you can protect your family after you’re gone! Well, it’s only a replica, but it’s a thoughtful gesture.

            Menzies and Menzies are psychologists and have treated many patients with mental problems. They argue that the fear of death is an underlying factor in many mental illnesses that seem to be about something else. An example is a spider phobia. A therapist might try to reassure a patient by saying, “Don’t worry, you’re not going to die just by looking at a spider.” The trouble is that the patient is going to die, eventually, of something. To say that a fear of death underlies many mental disorders might sound outlandish, but Menzies and Menzies cite some striking evidence in support, including that the level of people’s death fears correlates with mental health problems, medication use, hospitalisations and the recurrence of problems.


Rachel Menzies

Implications

If the fear of death has so many harmful consequences, what is to be done? The authors say, basically, accept that you will die and get on with life. They tell about the Stoics, the philosophers in ancient Greece who advised not to worry about things you can’t control. This is good advice generally and certainly applies to the fact that everyone dies.

            Menzies and Menzies also discuss funeral practices, noting that the practice of embalming — routine in the US — is environmentally damaging. They discuss the “death-positive movement” that promotes acceptance of death and has led to environmentally friendly options for burial.

            On a much bigger scale is human overpopulation, a factor in the environmental crisis. Menzies and Menzies say having children is a way to help deal with the fear of death, because children carry on our genes and our culture. Also, in most societies, having children is looked on favourably and thus helps build self-esteem, a buffer against the fear of death. This is plausible, and then there’s research showing that when men are asked how many children they would like to have, they give a higher number after having been subliminally reminded of death.


Warding off a fear of death?

            The authors also argue that people’s belief that the human species is immune to disaster, including catastrophic global warming, derives from an inability to face death. You may not agree with all these assessments, but the stakes are potentially high. If you turn away from the evidence and arguments presented in Mortals, does that reflect an aversion to thinking about your own death?

            Reminders of death are all around us, in the news and entertainment, though this varies a lot depending on the culture. I started this post by mentioning death, and that should have influenced your thinking, at least in the short term. It’s definitely worth learning about how reminders about death affect us, so if you can stand an intense yet engaging tour of death-related topics, why not read Mortals?


Ross Menzies

Brian Martin
bmartin@uow.edu.au

Thanks to Chris Barker, Kelly Gates, Emily Herrington and Julia LeMonde for helpful comments.

Who’s afraid of The Real Anthony Fauci?

Robert F. Kennedy Jr.’s book The Real Anthony Fauci has sold over a million copies and was on best-seller lists for weeks. Yet, apparently, it has not been reviewed in the US mainstream media. This intrigued me.

            Since the beginning of the pandemic, I’ve been following arguments from a range of perspectives: the Covid orthodoxy — which keeps changing — and a diversity of critics. It was hard to avoid hearing about Kennedy’s book, published in November 2021, but I thought it probably addressed issues regularly canvassed among sceptics about Covid orthodoxy.

            I read about attacks on Kennedy and his book published in the New York Times and elsewhere, attacks that did not address the contents of the book (Brown, 2022). Still, that wasn’t enough to get me to read it. Then I read a commentary by Phillip Adams (2022), a prominent progressive voice who has a column in The Australian, otherwise a bastion of conservative opinion. Disappointingly, Adams disparaged Kennedy, calling him a “full-time conspiracy theorist,” and dismissed his book as “a long diatribe that would appeal to anti-vaxxers” without saying anything about the book’s contents. That did it: I resolved to read the book myself.


Robert F Kennedy Jr.

            The Real Anthony Fauci is about Fauci, to be sure, but in a wider sense it is about the pharmaceutical industry and its hold over the US and global health system. Fauci is the hook for a more wide-ranging examination.

            I am a social scientist, not a physician or medical researcher, and have not attempted to get to the bottom of claims and counter-claims about Covid and health matters more generally, for example studies of hydroxychloroquine or adverse reactions to vaccines. But based on a long study of the politics of health, it is possible to make some judgements about whether Kennedy’s analysis is compatible with scholarly treatments.

            The Real Anthony Fauci is a lengthy tome, massively referenced. Kennedy acknowledges a “team of researchers and fact checkers who sourced, cited, and fact-checked this manuscript” (p. xii), and indeed there are lots of “facts” in the book, more than a single investigator might expect to verify in a few years. The book is available in electronic form and in print which, due to the small font and narrow margins, is not appealing to the eye. Even so, I preferred to read the print version. There is no index.

            Another issue is the organisation of material. For the most part, the chapters are coherently written, but occasionally there are digressions, some of them reprising themes covered elsewhere. In other words, the book is not as tightly constructed as it might be. On the other hand, it is quite up to date, suggesting it might have been rushed to publication.

            In the following, I look in most detail at Kennedy’s treatment of Covid issues, and then turn to some other parts of The Real Anthony Fauci.

Pandemic matters

Many readers will be most interested in chapter 1, “Mismanaging a pandemic,” a lengthy and up-to-date treatment. Much of the chapter is on treatments for Covid, specifically hydroxychloroquine, ivermectin and remdesivir. Kennedy’s argument is that US health authorities and media followers tried to discredit cheap, safe and effective treatments, meanwhile promoting expensive, dangerous, less effective and inadequately studied responses.

            Here’s the story in brief, as presented by Kennedy. Hydroxychloroquine and ivermectin have been used for decades for a variety of health problems and have well-researched safety profiles. Some doctors and researchers thought they looked promising as treatments for Covid, tried them on patients and obtained positive results, often in protocols also involving zinc, vitamin C, vitamin D, quercetin and other supplements and medications.

            The US medical establishment, in which Fauci played a key role, did not initiate a massive research effort to see whether these protocols were effective. Instead, they poured money into a patented treatment drug, remdesivir, and into the development of vaccines. Then, when some doctors and researchers championed hydroxychloroquine and ivermectin, Fauci et al. mounted an attack on these two drugs and tried to deregister or discredit their supporters. You might have heard ivermectin referred to as a “horse dewormer,” making it seem ill-advised for human use. Media coverage with this sort of depiction seldom mentions that doctors regularly prescribe drugs “off-label.” Calling ivermectin a horse dewormer reminded me of antifluoridationists who call fluoride “rat poison.” Sodium fluoride is indeed used as rat poison but only in doses far greater than can be obtained from the fluoride added to public water supplies to reduce tooth decay. Similarly, that ivermectin is used as a horse dewormer should not automatically discredit its use, in much smaller doses, as a preventive or early treatment drug for Covid.

            Kennedy documents a massive campaign to discredit hydroxychloroquine and ivermectin. This campaign had a research dimension. Some studies of hydroxychloroquine used it only on seriously ill patients when, according to proponents, it is least effective. Kennedy says researchers set up their studies to show hydroxychloroquine didn’t work.

            Then there was a major paper published in the prestigious medical journal The Lancet based on nearly one hundred thousand patients in numerous hospitals, definitively showing hydroxychloroquine was ineffective. It seemed like the coup de grace until it was revealed that the data could not be verified. The company running the study apparently organised a giant fraud. The Lancet retracted the paper.

            Why should there be such a campaign against cheap drugs that showed promise in treating Covid? Kennedy gives an answer: the US Food & Drug Administration, by law, cannot approve a vaccine for emergency use if there is an available treatment. Pharmaceutical companies, then spending vast amounts of money developing Covid vaccines, would not have their vaccines approved quickly if hydroxychloroquine, ivermectin or other therapies were shown to be effective as treatments.

            Kennedy quotes supporters of these two drugs saying that if they had been widely available in the US, hundreds of thousands of lives could have been saved. Instead, according to Kennedy, the CDC (Centers for Disease Control and Prevention), in an unprecedented move, ordered doctors to stop prescribing ivermectin, bought up stocks so they would not be available for sale, and encouraged pharmacists to refuse to fill doctors’ prescriptions.

            Meanwhile, Fauci’s favoured treatment drug, remdesivir, was pushed through the approval process despite studies showing minimal benefits and a high-risk profile. According to critics quoted by Kennedy, the use of remdesivir contributed to the death toll from Covid in the US.

            Then came the vaccines. Kennedy provides figures showing Covid vaccines are far less than fully effective and cause far more adverse reactions than officially reported.

            The underlying motive, or factor, is clear enough: pharmaceutical company interests. Hydroxychloroquine and ivermectin are not under patent, and a course of either one costs only a few dollars, so there is little money to be made from them. In contrast, remdesivir and Covid vaccines were financial bonanzas, offering profits of billions of dollars.

            This story is a damning indictment of the US medical establishment, basically saying that cheap and effective treatments were discredited and made hard to obtain so that proprietary drugs and vaccines, with dubious safety profiles, could become the preferred way to deal with Covid, all at the expense of large numbers of lives. This story is almost a reversal of the views presented by government officials and the mass media, in which hydroxychloroquine and ivermectin are suspect and vaccines the only long-term solution.

            Is Kennedy’s analysis of pandemic politics compatible with viewpoints expressed in the field of social analysis of health and illness? To address this question, I look in turn at four areas: undone science, analyses of big pharma, the role of Fauci, and suppression of dissent.

Undone science

David Hess, professor of sociology at Vanderbilt University and author of many works on science and health, developed the concept of “undone science” (Hess, 2016). It refers to research that could be undertaken, and is called for by civil-society groups, but is not pursued because the findings might be unwelcome to powerful groups. Undone science is most commonly found in the areas of environment and health. Hess focuses on undone science involving environmental risk, but the concept can also be applied to vaccination safety research.

For many years, critics have called for comprehensive studies comparing the health of unvaccinated and fully vaccinated children (e.g., Golden, 2019), but governments have not funded any such studies. It could be that such studies would definitively show the benefits of childhood vaccines but there is a risk they might show harms greater than publicly acknowledged. So this research remains undone except for relatively small studies not funded by governments or vaccine manufacturers.

            The concept of undone science sidesteps debates about the nature of knowledge, focusing instead on research agendas. It can be slightly broadened by referring to topics that companies or governments investigate but then do not publish their findings.

            Kennedy’s account of hydroxychloroquine and ivermectin fits perfectly in the model of undone science. Despite calls from doctors and patient groups for studies of these and other cheap and widely used drugs for Covid, pharmaceutical companies and governments did not urgently pour billions of dollars into studies. They basically ignored these calls, instead channelling their research dollars towards proprietary options. This does not prove that hydroxychloroquine and ivermectin are effective, but it does suggest that the way the medical establishment responded to calls for studying these drugs fits a well-established pattern.

Big pharma

It may seem shocking to imagine that companies making billions of dollars would compromise the health of populations just so they could make more billions. Is this plausible?

            In the 1960s, the German drug company Grünenthal marketed a morning sickness drug, promising wonderful effects. The company began receiving reports from doctors that their patients were suffering serious side effects from the drug, including peripheral neuropathy. Grünenthal ignored the reports and continued marketing the drug, and in some cases tried to discredit the doctors. This might have continued indefinitely, but then reports were published about pregnant women on the drug giving birth to children with serious deformities. This was enough to have the drug withdrawn from sale. Despite the damning evidence, Grünenthal denied responsibility and fought lengthy legal battles to avoid paying compensation (Insight Team, 1979).

            This is the story of the drug thalidomide, which became a famous emblem of corporate culpability. Was Grünenthal’s behaviour an outlier or a sign of things to come?

            Consider the tactics used by Grünenthal: marketing a drug before it had been sufficiently tested, ignoring reports of adverse effects, attacking critics and undertaking protracted legal means to avoid paying compensation — and never admitting wrongdoing. For some, it may be hard to believe companies could act in such a way. After all, they present themselves as supplying valuable solutions to health problems. Could they really be corrupt, enriching the pockets of executives and shareholders at the expense of public health?

            According to a range of critics, the answer is yes. The story of thalidomide became notorious but the same pattern has been repeated many times, except with less adverse publicity: the companies have become more sophisticated in their efforts to make exceptional profits without accountability.

            Ben Goldacre is a doctor and science journalist who wrote a scathing attack on alternative medicine, Bad Medicine (Goldacre, 2008). Then a few years later, he wrote Bad Pharma, an exposé of the pharmaceutical industry, giving example after example of how researchers studying drugs for companies fudge their results, for example by fixing endpoints, ignoring adverse effects and using physiologically active placebos. Bad Pharma provides revealing stories of what might be called systematic scientific fraud (Goldacre, 2012).

            Sergio Sismondo is a prominent figure in the field of science and technology studies, among other things having been editor of the premier journal Social Studies of Science for many years. He undertook a detailed investigation of the publication and marketing practices of pharmaceutical companies, for example attending conferences for pharmaceutical company liaisons and sales representatives, who use various forms of persuasion to encourage doctors to prescribe favoured drugs. In his book Ghost-managed Medicine, Sismondo (2018) documents the process by which company researchers produce papers for publication in top medical journals, finding academics who have had little or no involvement in the research to be the nominal authors, thereby giving the papers greater credibility. After publication, these papers are distributed to as many as hundreds of thousands of doctors as part of well-coordinated marketing efforts. In Sismondo’s picture, medical research is a just part of a marketing enterprise.

            Peter Gøtzsche is a medical researcher who helped set up the Cochrane Collaboration, a network of independent scientists who carry out assessments of drugs and other medical interventions. Gøtzsche himself is a highly energetic investigator and a fierce critic of shoddy research and corrupt practice. In his book Deadly Medicines and Organised Crime, Gøtzsche (2013) gives numerous examples of pharmaceutical companies that market products they know are dangerous. He says the pharmaceutical industry is just like organised crime in knowingly harming people, the main difference being that the industry kills far more people than organised criminals.

            In addition to analyses by Goldacre, Sismondo and Gøtzsche, one can turn to indictments by former editors of major medical journals (Angell, 2005; Smith 2005). Then there are pharmaceutical company whistleblowers who have told about corrupt practices from an inside perspective, as well as about the reprisals they suffered for speaking out (Rost, 2006).

            In this context, Kennedy’s analysis of Covid politics is nothing surprising. It is plausible that companies would promote responses to the pandemic that serve their own interests, even at the potential cost of large numbers of lives.

            But how could scientists and executives do such a thing? For the scientists, it is straightforward: they are part of a larger system, and they can just focus on their own narrow tasks (Schmidt, 2000). For executives and others, belief systems are convenient. They can truly believe that they are serving the public interest — or they can adopt any of various justifications for their actions. It’s not necessary to imagine that those who promote medical interventions as the solution to the pandemic have some secret agenda, scheming to cull the population. There is a well-known precedent, after all: the tobacco industry, responsible for the premature death of tens of millions of people (Proctor, 2012). We don’t need to think big tobacco is run by homicidal maniacs with a secret agenda. Well, they do have secrets, but for the purpose of maintaining and expanding markets for their products and making more money.

The role of Fauci

Kennedy’s book is titled The Real Anthony Fauci so it is hardly surprising that Fauci plays the lead role in Kennedy’s account of responses to Covid. Kennedy says relatively little about the politics of treatments and vaccines outside the US, except in as much as they support his argument. Is it reasonable to blame Fauci personally for so much of Covid policy?


Anthony Fauci

            One alternative is to use a structural analysis, standard in social science, that focuses on institutions and processes and sees individuals as epiphenomena. In this sort of picture, the drivers of the responses to the pandemic include the pharmaceutical industry which created the basis for a Covid paradigm — a hegemonic way of understanding Covid and what to do about it — that serves to support the industry’s interests. Responses to the pandemic were also influenced by political leaders who gained support by implementing tough policies, from the mass and social media that gave saturation coverage of the Covid threat without much historical or social context, and audiences frightened by a Covid hysteria and who looked to authorities for protection.

            Using this sort of structural analysis puts Fauci in a different light. He may have had an outsized influence on developments, but if someone else had been in his position, the outcome may not have been all that different. How to assess the value of a Fauci-centred analysis as compared with a structure-centred analysis is not straightforward. One way to proceed might be to undertake a comparative analysis of Covid responses in different parts of the world, looking at the roles of key individuals and policy decisions. For example, is the Swedish policy, widely seen as a contrast with policies in other European countries, better explained by Swedish history and institutions or by the influence of key individuals, or some combination?

            Kennedy’s focus on Fauci can also be understood as a narrative device, as a way of creating interest in the story. Readers may be more attracted by a story of a scheming individual than by the operations of faceless organisations and sets of ideas. You are reading Kennedy’s story about Fauci, the master manipulator at the centre of a web of influence, and learning about drugs, policies and much else along the way, without having to plough through the sort of prose found in a sociology monograph.

Suppression of dissent

In a revealing passage (pp. 142–143), Kennedy tells how for years he was able to have articles published in major newspapers and was widely sought after as a speaker on environmental issues. Then in 2005 he wrote an article about corruption in CDC’s vaccine branch, published in both Salon and Rolling Stone — and everything changed. His articles were removed, newspapers henceforth refused to publish his articles, and speaking engagements dried up due to complaints to venues or hosts.

            Throughout The Real Anthony Fauci, Kennedy describes how critics of orthodoxy have been suppressed, including losing their funding, being deregistered and being subject to derogatory misrepresentations. For example, in the 1970s, distinguished scientist J. Anthony Morris questioned the promotion of a flu vaccine. Kennedy describes the methods used against Morris: “… enforced isolation, disgrace, prohibiting him from publishing papers, presenting at conferences, or talking to the press, changing his laboratory locks to prevent further research …” (p. 360). I had read about this case earlier (Boffey, 1976).

            Based on my studies of “suppression of dissent” (Martin, 1999, 2015), this aspect of Kennedy’s account is completely believable. What he describes accords with experiences reported by hundreds of other scientists and campaigners.

Pandemic matters: summary

Kennedy provides a hard-hitting critique of US pandemic policy. Contrary to the official narrative that vaccines are the salvation and that hydroxychloroquine and ivermectin are kooky or dangerous, Kennedy argues that these two generic drugs, if used appropriately, are potent treatments for Covid. If they had been recognised and widely used, they might have reduced the US Covid death toll by hundreds of thousands. Accepting them as valid treatments, though, would have meant that Covid vaccines should not have received emergency use authorisations, and the proprietary drug remdesivir would not have been favoured. Behind this scandal, Kennedy says, is Anthony Fauci, the Covid-response kingpin whose actions faithfully served the pharmaceutical industry at the expense of public health. If Kennedy’s account is accepted, it points to one of the greatest scandals in the history of US public health.

            As a way of reflecting on Kennedy’s claims, I asked myself whether his analysis is compatible with analyses in the sociology of health and illness. Overall, it is. It is well documented that the pharmaceutical industry often has pursued profits over patient health, has silenced, discredited and suppressed those who challenge its agendas, and has colonised the medical profession to serve its own ends. Sociologists would probably not place so much importance on a single person, Fauci in this case, as being responsible for abuses, but instead would point to institutional and systemic processes, but this does not change the basic compatibility of Kennedy’s account with scholarly perspectives. This does not mean Kennedy’s account is right, just that it should not be ruled out as implausible. If it is considered a conspiracy theory, it might well be about a real conspiracy. I now turn to some other parts of The Real Anthony Fauci.

AIDS

Kennedy, after looking at Covid, turns to earlier stages in Fauci’s career, especially concerning AIDS. From the 1980s, Fauci was involved in the US response to AIDS, which was first diagnosed in 1981. For treating AIDS, Fauci championed the drug AZT, which turned out to be highly toxic.

            Kennedy, to show Fauci’s intolerance of contrary views, gives extensive commentary on the view that HIV is not responsible for AIDS, or not fully responsible. Starting in the late 1980s, this HIV-AIDS heresy was championed by Peter Duesberg, a highly prominent virologist. Previously he had received generous, prestigious funding for his research; after questioning HIV-AIDS, he was vilified and all his grant applications failed. He had difficulty publishing scientific papers, even in venues where normally he had guaranteed access.

            I have long been aware of HIV-AIDS dissent and the treatment of Duesberg, even citing it as an example of heresy in medicine. However, I never delved into the issue deeply, in large part due to my involvement in another AIDS debate, specifically the theory that AIDS developed from contaminated polio vaccines used in central Africa in the late 1950s. In 1991, I arranged for the publication of a working paper about this view (Pascal, 1991), which led to close contact with several of the key figures in the debate over the origin of AIDS, including the indefatigable investigator Edward Hooper (2000).

            Not long after the discovery of HIV, the human immunodeficiency virus, in 1983, a related virus was discovered in monkeys, simian immunodeficiency virus, SIV. Immediately, scientists speculated that SIV — of which there are many variants — had somehow gotten into humans and become transmissible. The question was how. One suggestion was that it was from people eating monkey meat. Another was that a hunter, in butchering a monkey, got monkey blood in a cut. This view can be called the cut-hunter theory or the bushmeat theory.

            Then there was the polio-vaccine theory. Polio research pioneer Hilary Koprowski ran trials involving polio vaccines that were administered orally to up to a million people in central Africa. These vaccines were cultured on monkey kidneys, offering a pathway for contamination by SIVs. Many scientists intensely disliked this theory. Naturally, the polio pioneers accused of accidentally causing AIDS were strong opponents, and a number of others joined them. I had a front-row seat in seeing the underhanded techniques used to censor and discredit the polio-vaccine theory, including blocking publications, suing for defamation, manipulating a scientific conference and making false claims (Martin, 2010).


Hilary Koprowski

            With this experience, it is easy to say that Kennedy’s treatment of Duesberg and HIV-AIDS dissent fits a pattern of suppressing dissent from AIDS orthodoxy. The question that came to my mind was, why did Kennedy give so much attention to the HIV-AIDS dissent and not even mention the origin-of-AIDS controversy? An obvious factor is that Fauci was centrally involved in the response to Duesberg and his allies but played no role in the response to the polio-vaccine theory.

            Kennedy states that “From the outset, I want to make clear that I take no position on the relationship between HIV and AIDS.” (p. 178). Nevertheless, in writing about HIV-AIDS, he gives extensive explanations of the viewpoint of Duesberg and other dissidents, focusing almost entirely on AIDS in the US. In this perspective, early US AIDS cases were attributable to poppers and other drugs used widely in the gay community, and later cases were due to AZT, the drug widely used to treat AIDS, with toxic consequences. This is a cogent account of the case that HIV is not responsible for AIDS. But it is one-sided. Nowhere does Kennedy mention evidence that might be difficult for Duesberg to explain. Why, for example, are the earliest cases of HIV-positive blood traced to central Africa from 1959 and after? Why did Ugandans recognise Slim, the local name for AIDS, as a new disease at the start of the 1980s, just as HIV appeared there? (Hooper, 2000, pp. 168–169). If HIV is simply a passenger virus, as Duesberg argues, why did it seem to emerge about the same time as the earliest cases of AIDS, and in the same location? I’m aware that Duesberg and his supporters can come up with explanations for anomalies like this. My point is that Kennedy has given only the information that HIV-AIDS dissidents can more easily explain.

A fatal flaw?

One-sidedness is a feature throughout The Real Anthony Fauci. Earlier I described Kennedy’s writing about Covid, specifically about hydroxychloroquine, ivermectin, remdesivir and vaccines. In relation to hydroxychloroquine and ivermectin, Kennedy writes like a lawyer for the defence; in relation to remdesivir and vaccines, he writes like a prosecutor.

            Is this a fatal flaw in his arguments? If it is, the same fatal flaw is present in most of the writing giving the standard, official views about Covid, which offer no acknowledgement of any contrary evidence. For example, official pronouncements about hydroxychloroquine never cite the many studies showing its effectiveness against Covid. In this context, Kennedy is presenting views to counter a one-sided orthodoxy. Furthermore, he is confronting an establishment committed to censorship and suppression. He has taken his opportunity to present a challenging view in as strong terms as he can manage. Nearly all of his readers will be fully aware of the orthodox view, which is dominant in mainstream sources and which shapes policy. So, in a sense, Kennedy might be excused for being one-sided.

            It’s useful to remember that The Real Anthony Fauci has been a bestseller that has received no reviews in mainstream media, only attacks. If Kennedy’s arguments are so dangerous, why not respond to them in a careful manner rather than trying to censor the message and discredit the messenger? One consequence of official intolerance of dissent is that some of those with reservations about the official line will find a well-documented presentation of contrary views persuasive. They might feel their only choices are orthodoxy or a Kennedy-informed heterodoxy.

Gates

The subtitle of Kennedy’s book is Bill Gates, Big Pharma, and the Global War on Democracy and Public Health. Bill Gates, the co-founder of Microsoft, is well known as one of the world’s richest people. He and his former wife set up the Bill and Melinda Gates Foundation which has dispensed billions of dollars for the cause of public health. At the same time, many commentators in the Covid-critical community see Gates as an evil manipulator, one who might even have depopulation as part of a sinister agenda.


Bill Gates

            Kennedy quotes critics of Gates’ so-called “philanthrocapitalism” who point out that the Gates Foundation, while giving away large amounts of money, is becoming even wealthier, as indeed has Gates himself. The explanation is Gates’ investments in pharmaceutical companies and the Gates Foundation’s focus on vaccination as the solution to the world’s health problems, especially those in Africa.

            According to Kennedy, the Gates Foundation, by making generous donations, has colonised international bodies like the World Health Organization, major research bodies and the mass media. In Africa, Gates promotes vaccines while long-time development experts say primary health care is more important. The money poured into vaccines has meant neglect of the basics, including adequate food and clean water. In other words, Kennedy says, Gates’ prioritising of vaccines is serving the interests of pharmaceutical companies rather than those of people in need. Throughout his book, Kennedy makes the point that Fauci, Gates and those in their thrall put disproportionate emphasis on vaccines and drugs while neglecting efforts to build people’s immune systems through better nutrition and hygiene. In summary: “… global public health advocates accuse Bill Gates and Dr. Fauci of hijacking WHO’s public health agenda away from the projects that are proven to curb infectious diseases (clean water, hygiene, nutrition, and economic development) and diverting international aid to wedge open emerging markets for their multinational partners and to serve their personal vaccine fetish.” (p. 323)

            Does this sound conspiratorial? It might, but there is no need to invoke conscious scheming. As studies of paradigms suggest, it is quite possible for Gates to be serving his own interests while sincerely believing that he is playing a life-saving role for hundreds of millions of people.

Intellectual property

A revealing indication of priorities is the role of intellectual property (IP) in public health. The rationale for IP, which includes copyright and patents, is to stimulate the production of new ideas and products by giving a temporary monopoly to the creator. I am one of many critics of IP, on several grounds (Martin, 1995). At the simplest level, the length of copyright terms, now standing at 70 years after an author’s death, is vastly longer than needed to stimulate more creative works. More generally, IP primarily benefits big companies in software, publishing, genetically modified foods, Hollywood entertainment — and pharmaceuticals.

            Intellectual property is a restraint on innovation justified by the need to stimulate more innovation, but big companies regularly use their controls to stymie competitors. This process is institutionalised in global agreements, most famously TRIPS (Trade-Related Aspects of Intellectual Property Rights). The US government has been the most aggressive in pushing to include stronger IP controls in trade agreements, even though for practical purposes IP restrains trade.

            Sometimes IP comes in direct conflict with public health. After AIDS drugs were developed, pharmaceutical companies charged exorbitant prices for them. Governments in low-income countries argued that these drugs should be compulsorily licensed so they could be made available at close to production costs and thereby be used to treat millions of AIDS patients who otherwise would not be able to afford them. The companies, backed by Gates and his entities, vigorously opposed this relaxation of tight IP controls. Gates, in software and drugs, put IP-derived profits above public health.

            Then came Covid and the same scenario, this time with vaccines and public health. The pandemic was proclaimed to be a public health emergency that warranted the most urgent efforts to develop vaccines that would be rolled out for the world’s entire population. But when governments asked for compulsory licensing so manufacturers of generics could provide otherwise unaffordable vaccines, the companies and Gates resisted.

            The willingness of big pharma and its government allies to fight against making their products available at low cost to fight pandemics — AIDS and Covid — is a damning indictment, yet it has received little media attention. Kennedy recounts how the Gates Foundation has made significant donations to media organisations, most of which muzzled themselves when it comes to any questioning of orthodoxy even when, as with licensing of drugs and vaccines, the realities of IP protection clash with public health priorities.

Depopulation?

Perhaps the most outlandish-seeming claims about Fauci and Gates are that they have a depopulation agenda. Kennedy addresses several versions, inadvertent and intentional.

            Inadvertently, some vaccine promotion efforts may lead to higher death rates. Scientist Peter Aaby and colleagues have studied the mortality of children in Guinea-Bissau following various vaccines (Aaby et al., 2018; Kristensen, 2000). The measles vaccine reduces mortality significantly but the DTP triple vaccine (diphtheria, tetanus and pertussis) increases mortality, quite dramatically for young girls. Years ago, the whole-cell pertussis component of DTP was found to be dangerous, so in the West it was replaced by an acellular version, with the resulting triple vaccine denoted as DTaP. However, as Kennedy reports, WHO, supported by Gates, continued to promote the more dangerous DTP version in Africa. This might be called an inadvertent depopulation process.

            Then there is the way vaccine promotion in low-income countries actually hurts population health by diverting money from basic measures such as providing clean water. Kennedy gives the example of the hepatitis B vaccine, promoted in India despite the disease it targets, hepatocellular carcinoma, not being a significant health problem in the country. Furthermore, according to Kennedy, Gates’ entities and allies pushed the WHO to include the hepatitis B vaccine in the mandated list of vaccines worldwide, irrespective of whether it addressed a significant problem. This meant governments paid large amounts to pharmaceutical companies for the vaccines; Gates has large holdings in these companies, so by giving money away he increases his fortune. By diverting scarce funds from more important health problems, this vaccine-promotion agenda could be said to be an inadvertent depopulation process.

            Then there are overt measures to control populations: promotion of anti-fertility drugs. Kennedy presents evidence suggesting that some vaccination programmes in low-income countries were covers for administering anti-fertility drugs, notably one called Depo-Provera. He cites writers who note that the schedule for giving the vaccines was one injection every six months for several years, rather than the usual pattern for the tetanus vaccine. Kennedy also refers to Gates’ longstanding interest in population control.

            The administration of anti-fertility drugs under the guise of vaccination, without proper consent, is obviously scandalous. However, even if true, it is not necessarily evidence of an intent to kill vast numbers of people, as might be suggested by the term “depopulation.” If Kennedy’s claims are correct, they are compatible with Gates sincerely seeking to address the problem of overpopulation, albeit sometimes with unethical means.

Conclusion

The Real Anthony Fauci is an impressive book, covering a wide range of important topics with extensive referencing. There is much more in the book that I have not discussed, including chapters on declaring pandemics and on biological warfare. I have not tried to pass judgement on Kennedy’s claims but rather to comment on whether his general perspective is compatible with some of the analyses by scientists and social scientists who have studied the same issues. For the most part, it is.

            The Real Anthony Fauci is, in parts, far more strident than typical scholarly treatments. In places, it reads like a diatribe, especially against Fauci and Gates. For example, Kennedy writes, “Blind faith in Saint Anthony Fauci may go down in history as the fatal flaw of contemporary liberalism and the destructive force that subverted American democracy, our constitutional government, and global leadership.” (p. 231). Many scholars would look less at the role of individuals and more at social structures, in particular at social systems that allow certain individuals to have an inordinate role in decision-making.

            A serious criticism of The Real Anthony Fauci is that it is one-sided. It presents lots of damning information but seldom attempts to present the other side, except to attack it. Discerning readers need to be aware that this is a critique of Covid orthodoxy and of the actions of the pharmaceutical industry and its most powerful supporters in government, science and philanthropy.

            The one-sidedness of the book might be considered, in context, a counter to the one-sidedness of the orthodox position concerning the pharmaceutical industry, Covid and vaccination. There is a certain symmetry here: both defenders and critics of orthodoxy give insufficient recognition to the other side. But there is a big difference. The defenders of Covid and pharmaceutical orthodoxy are backed by vast wealth and power, including the power to censor critics. The New York Times published attacks on Kennedy, meanwhile refusing to run an advertisement for his book (Lyons, 2022).

            There is one other difference between The Real Anthony Fauci and the many scholarly critiques that raise similar concerns: Kennedy’s book has sold over a million copies. In the age of Covid, it testifies to a widespread interest in seeing a well-documented perspective that questions the official line. That mainstream media decline to review the book or to address its claims shows the importance of a critique that reaches a wide audience.

Acknowledgements

For valuable comments on drafts, I thank Kevin Dew, Bob Dildine, Kurtis Hagen, Ed Hooper, Olga Kuchinskaya, Susan Maret and Sergio Sismondo. None of them necessarily agrees with Kennedy’s views or my own.

References

Aaby, Peter, Søren Wengel Mogensen, Amabella Rodrigues and Christine S. Benn. 2018. “Evidence of increase in mortality after the introduction of diphtheria-tetanus-pertussis vaccine to children aged 6–35 months in Guinea-Bissau: a time for reflection?” Frontiers in Public Health 6(79), 1–10.

Adams, Phillip. 2022. “Conspiracy of fools,” Weekend Australian Magazine, 19 February, 42.

Angell, Marcia. 2005. The Truth about the Drug Companies: How They Deceive Us and What to Do about It. New York: Random House.

Boffey, Philip M. 1976. “Vaccine imbroglio: the rise and fall of a scientist-critic.” Science 194 (December 3), 1021–1024.

Brown, Steve. 2022. “RFK, Jr.’s ‘The Real Anthony Fauci’ is a record-smashing bestseller — but mainstream media pretends it doesn’t exist.” Children’s Health Defense, February 17. https://childrenshealthdefense.org/defender/rfk-jr-the-real-anthony-fauci-record-smashing-bestseller/

Goldacre, Ben. 2008. Bad Science. London: Fourth Estate.

Goldacre, Ben. 2012. Bad Pharma: How Drug Companies Mislead Doctors and Harm Patients. London: Fourth Estate.

Golden, I. 2019. “Reluctance to vaccinate: reasons and solutions.” Journal of Translational Science 5, 1–6.

Gøtzsche, Peter C. 2013. Deadly Medicines and Organised Crime: How Big Pharma Has Corrupted Healthcare. London: Radcliffe.

Hess, David J. 2016. Undone Science: Social Movements, Mobilized Publics, and Industrial Transitions. Cambridge, MA: MIT Press.

Hooper, Edward. 2000. The River: A Journey to the Source of HIV and AIDS. Boston: Little, Brown. http://www.aidsorigins.com/the-river-a-journey-to-the-source-of-hiv-and-aids-2021-edition-by-edward-hooper/#more-3529

Insight Team of The Sunday Times (Phillip Knightley, Harold Evans, Elaine Potter and Marjorie Wallace). 1979. Suffer the Children: The Story of Thalidomide. London: André Deutsch.

Kennedy, Robert F., Jr. 2021. The Real Anthony Fauci: Bill Gates, Big Pharma, and the Global War on Democracy and Public Health. New York: Skyhorse.

Kristensen, Ines, Peter Aaby and Henrik Jensen. 2000. “Routine vaccinations and child survival: follow up study in Guinea-Bissau, West Africa.” BMJ 321 (December 9), 1–8.

Lyons, Tony. 2022. “We tried to run an ad for ‘The Real Anthony Fauci’ in The New York Times. Here’s what happened.” Children’s Health Defense, March 13. https://childrenshealthdefense.org/defender/ad-the-real-anthony-fauci-the-new-york-times

Martin, Brian. 1995. “Against intellectual property.” Philosophy and Social Action 21(3), 7–22. https://www.bmartin.cc/pubs/95psa.html

Martin, Brian. 1999. “Suppression of dissent in science.” Research in Social Problems and Public Policy 7, 105–135. https://www.bmartin.cc/pubs/99rsppp.html

Martin, Brian. 2010. “How to attack a scientific theory and get away with it (usually): the attempt to destroy an origin-of-AIDS hypothesis.” Science as Culture 19(2): 215–239. https://www.bmartin.cc/pubs/10sac.html

Martin, Brian. 2015. “On the suppression of vaccination dissent.” Science and Engineering Ethics 21(1), 143–157. https://www.bmartin.cc/pubs/15see.html

Pascal, Louis. 1991. What Happens When Science Goes Bad. The Corruption of Science and the Origin of AIDS: A Study in Spontaneous Generation. Working Paper No. 9, Science and Technology Studies, University of Wollongong, Australia. https://www.bmartin.cc/dissent/documents/AIDS/Pascal91.html

Proctor, Robert N. 2012. Golden Holocaust: Origins of the Cigarette Catastrophe and the Case for Abolition. Berkeley, CA: University of California Press.

Rost, Peter. 2006. The Whistleblower: Confessions of a Healthcare Hitman. Brooklyn, NY: Soft Skull Press.

Schmidt, Jeff. 2000. Disciplined Minds: A Critical Look at Salaried Professionals and the Soul-Battering System that Shapes their Lives. Lanham, MD: Rowman & Littlefield.

Sismondo, Sergio. 2018. Ghost-managed Medicine: Big Pharma’s Invisible Hands. Manchester: Mattering Press. https://www.matteringpress.org/books/ghost-managed-medicine

Smith, Richard. 2005. “Medical journals are an extension of the marketing arm of pharmaceutical companies.” PLoS Medicine 2(5), e138. https://doi.org/10.1371/journal.pmed.0020138

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Brian Martin
bmartin@uow.edu.au

Can you focus as well as you’d like?

What do gym-goers think about when they’re lifting weights? I don’t know, but in recent years I can see what half of the gym-goers are looking at between sets: their phones. Some become so engrossed that they seem to forget, for a while, that they’re at the gym.

            Outside, walking along, when I come up behind a young person who is walking slowly, I guess they’re multitasking: walking and checking their phone. Usually they are.

            For years I’ve been fascinated with attention, including what we pay attention to and how we maintain it. Part of the challenge is having some control over our attention when others are trying to hijack it, for their own purposes. You might be trying to read but the children want you to do something with them. Or you get a call from a friend. Sometimes interruptions are welcome, such as when you’re doing a boring task and you need a break.

            Interruptions from children and friends are one thing. Interruptions for commercial purposes are another. For quite a few years I’ve been reading about how advertisers seek to capture people’s attention.

            For an eye-opening survey of media and attention, see Tim Wu’s book The Attention Merchants: The Epic Scramble to Get Inside Our Heads. Wu tells how US and UK military propaganda methods were adopted by advertisers, who then pioneered more effective methods. According to Wu, the standard method for capturing your attention is to offer something for free — or just seeming to be free — and then resell your attention to advertisers. Because attention is scarce and there is competition, the race heads downwards, seeking to engage with the intuitive mind and sidestep the rational mind. From The Attention Merchants I learned a different way of understanding developments in television, celebrities, blogging, Facebook and much else. My blog post.

            For understanding how social media have become so good at capturing attention, turn to Adam Alter’s book Irresistible: Why We Can’t Stop Checking, Scrolling, Clicking and Watching. It’s a highly engaging account of behavioural addictions, covering evidence for their rise (especially via smart phones), addictive tendencies, the biology of addiction, the engineering of behavioural addiction through goals, feedback, escalation, cliff-hangers and social interaction, and what to do about it. Alter provides a stimulating treatment of gamification, in which activities are turned into games. He addresses how habits are formed. My blog post.

Stolen focus

Then I heard about Johann Hari’s new book addressing attention. I had learned a lot from his first two books, Chasing the Scream about the war on drugs and Lost Connections about depression. Hari writes in a highly engaging way, telling about his search for answers to crucial questions, drawing on his own experiences and interviews with key participants and researchers.

            Hari’s new book is titled Stolen Focus: Why You Can’t Pay Attention. He starts with the observation that many people don’t seem to be able to focus for as long as they used to. He tracks down researchers who have studied the capacity to focus. They say the evidence does show that, on average, people’s capacity to focus is declining. Hari wants to find out why.

            He first tackles the most obvious explanation: social media and apps. You might think you are in control of what you do when using your phone. Think again.

            Hari interviewed a former Google engineer, Tristan, who says that success for Google workers was getting more people engaged, in other words hooked. This was not a nefarious plot but simply maximising income: engagement brings in more money from advertisers. At Google and elsewhere in Silicon Valley, no one thought about what they were doing to people’s attention.

            When you use your smartphone, the phone is smarter. The apps are designed by some of the smartest people on the job market to capture your attention. Hari lists several ways that websites and apps are designed that harm attention.

  1. They train your mind to crave rewards – frequent ones.
  2. They encourage you to switch tasks. Task-switching disrupts attention.
  3. They learn what make you tick and use what they learn to distract you and keep you on the platform.
  4. They make you angry, because being angry keeps you engaged. The result is that online, condemning rather than understanding has become the norm.
  5. They make you feel like you’re surrounded by angry people, though this is partly a result of getting everyone engaged.

The result is that your capacities — your intelligence, rationality and focus — and those of others are downgraded.

            What should be done? Why not just take control? Switch off notifications. Unsubscribe from lists. Set your phone to be offline for designated periods. When you go to bed, put it in another room. Hari talked with Nir, who helped develop engrossing apps and then wrote a book about how to resist them. Hari agrees that individuals can do a lot to protect themselves from perpetual distraction, but it’s not enough. When users are up against highly sophisticated algorithms designed to bypass rational controls, only a few have the resources to resist effectively.

            Hari supports individual efforts but thinks collective action is needed to bring websites and app design into a different model, one that supports users rather than exploits them. He gives a nice example of what could be done. It would be simple to develop an app to tell you about everyone in your neighbourhood who would like to go out for dinner, right now. But such an app isn’t available because it would help people go offline.


Johann Hari

What else?

A good portion of Stolen Focus is about devices that hijack your attention, but Hari thinks there are other factors, and continues his explorations. Another important contributor is insecurity. If you’re worried about your job or being able to pay your bills, then it’s harder to concentrate. With the rise of the gig economy in which many people can only obtain insecure and irregular employment, it is no surprise that anxiety levels escalate and attention suffers. Hari argues that a UBI, a universal basic income that is provided to everyone with no strings attached, would do a lot for people’s attention, and for their happiness as well.

            Another factor is your diet. Do you ever binge on junk food? When you aren’t getting enough nutrients, that’s a problem. When you get too much sugar, then after a while your blood sugar level crashes, and your capacity to focus suffers. Add to this environmental chemicals that can affect the brain, especially kids’ brains. Hari says added chemicals in food, as well as ones in the environment, are damaging to attention.

            Finally, Hari explores the way that children, in many affluent societies, are continually monitored. Due to exaggerated fears of child abductions and the promotion of “stranger danger,” many parents no longer allow their children to walk or cycle to school or to play unsupervised. Actually, says Hari, children need the opportunity to organise their own activities. Adults, by their excessive oversight, are not meeting their children’s needs.

Here’s how he summarises the impact of several of the factors he explored:

“We don’t let them play freely; we imprison them in their homes, with little to do except interact via screens; and our school system largely deadens and bores them. We feed them food that causes energy crashes, contains drug-like additives that can make them hyper, and doesn’t contain the nutrients they need. We expose them to brain-disrupting chemicals in the atmosphere.”

This is quite an indictment, but there’s only so much an individual can do. Many of the processes Hari describes are hard to escape unless you are really privileged. If you’re Bill Gates and own a small island, you can go there to get away from interruptions. Otherwise, you’re largely on your own — unless you join up with others to bring about change. Hari says there needs to be a social movement to regain the capacity to focus, a movement to support people engaging in the experience of flow in which you become totally engrossed in an activity requiring you to exercise your skills.

            As a clincher, Hari says the people of the world need their attention to deal with serious problems such as climate change. This sounds good. I followed Hari all the way with his explorations, and definitely think it’s worthwhile to cultivate the capacity to focus, and to use it regularly — including to read every word of Stolen Focus. The problem is that the power of attention can also be turned to less noble purposes such as building weapons and constructing ads. Yes, let’s join together to protect and restore our capacities to focus, but also join together for goals that help others.

Brian Martin
bmartin@uow.edu.au

Understanding resistance to vaccination

Those who don’t support vaccination are often seen as irrational. Yet, on closer inspection, the issues are not so clear-cut. Condemning “anti-vaxxers” might even be counterproductive. Better is understanding resistance to vaccination.

Given the positive connotations of “resistance” — often thought of as valiant opposition to unfairness — it might seem wrong to give this label to anyone who does not fully support vaccination, the rationale being that they are being selfish and endangering public health. Whatever your view, it can be useful to better understand the psychology and politics of vaccination.

“Resistance to vaccination” can take many forms. It includes accepting some vaccines but not others, spacing out injections, openly questioning official vaccination policies, and publicly protesting vaccination mandates. Resistance can be individual or collective.

With the advent of Covid-19, vaccination has become a high-profile personal and political issue, with nearly every adult needing to make a personal decision about whether to be vaccinated and how to relate to others depending on their vaccination status. I address resistance to Covid vaccines later.

Personally, I do not have strong views about vaccination. My interest in the vaccination issue comes from supporting the free speech of Australian vaccination critics who came under severe attack over many years.

Background

From the very first vaccine, for smallpox, there was resistance. In the 1800s in England, mandates triggered greater resistance, and even mass protests.

            In the second half of the 1900s, vaccines were introduced for an increasing number of infectious diseases, including polio, measles, pertussis (whooping cough), mumps, chickenpox and others. Most of these vaccines are recommended for children rather than adults, thus introducing an extra consideration: parents need to make vaccination decisions for their children who are too young to give informed consent.

Governments and medical authorities throughout the world recommend vaccination against a range of diseases, though the number of vaccines and preferred ages differ somewhat. Some governments apply strong pressures for vaccination whereas others do not. The greater the official and social pressures, the more relevant is the concept of resistance.

Arguments

For those who support vaccination, the arguments are pretty straightforward, summarised by the slogan “Vaccination saves lives.”

In particular, vaccines are designed to improve immunity against specific diseases, thus providing a benefit to the vaccinee (the person who is vaccinated). However, some people cannot be vaccinated or do not develop adequate immunity, for example cancer patients receiving chemotherapy who have a reduced immune function. These people are protected from infection when nearly everyone around them is immune. More generally, when nearly everyone is immune, infections have a hard time spreading. This sort of protection of those without immunity is a collective benefit.

Vaccination thus has two sorts of benefit, personal and collective. The collective benefit is often treated as generating a moral imperative that everyone should be vaccinated, to protect those with impaired immunity.

            Before proceeding further, it’s necessary to say that nearly every important claim about vaccination is disputed by some partisans — that includes both individual and collective benefits.

Turning to arguments against vaccination, the most influential is the possibility of adverse reactions to vaccines, including illness, disability and death. Critics claim adverse reactions are far more common than normally recognised. Another argument follows the line of thinking that some diseases — for example mumps — are usually harmless in childhood and give better immunity than vaccines.

Most early vaccine developers — for example, the polio vaccine pioneers Jonas Salk and Albert Sabin — gifted their discoveries to the public: they did not try to commercialise their vaccines. Beginning in the 1980s, pharmaceutical companies sought to profit from vaccine development and sales. This fed into concerns felt by some parents that the profit motive might be compromising safety.


Jonas Salk

            Decades ago, only a few vaccines were standardly available and recommended. More were added year by year, so in the US a child is now recommended to receive dozens of vaccine doses for numerous diseases. The great increase in the number of vaccines has contributed to parental reservations, especially for diseases that are rare or usually mild.

Sociologists have interviewed parents who have concerns about childhood vaccines. One of their findings is that parents with hesitations are usually well informed, well educated, and care a great deal about their children’s wellbeing. Few of them fit the caricature of being anti-rational or obsessed with conspiracy theories.

When a child seems to have an adverse reaction to a vaccine, the parents often report that doctors and health officials are sceptical, even contemptuous. These hostile attitudes can be counterproductive, causing parents to become alienated from mainstream medicine. Parents with reservations gravitate to places where they can share experiences without being shamed. When they discover vaccine-critical citizens groups, they may feel at home.

            Numerous writers about vaccine hesitancy lay blame on “anti-vaccine” information on the Internet, promulgated by campaigners. Yet it may be the other way around: vaccine-critical groups may be driven more by common experiencesthan by winning recruits through fear-mongering. A study of members of the Australian Vaccination-risks Network found that most had concerns before they joined. The implication is that such groups are more the product than the cause of concerns about vaccination.

Forms of resistance

Many parents who decide not to follow official vaccination recommendations try to keep a low profile, especially in places where unvaccinated children are stigmatised. In these cases, resistance is individual and not publicised.

When pressures to vaccinate become stronger, the stakes are raised and resistance can have bigger effects on both children and parents. In some US states, to attend school the option of religious and conscientious objection has been removed and obtaining medical exemptions made more difficult. Parents can resist this sort of pressure by finding a sympathetic doctor, moving to a different state or home-schooling.

The stronger the pressures, arguably, the more likely some parents are to seek information and support from vaccine-critical groups. Strong pressures can sometimes foster the resistance they are supposed to overcome.

            In Australia, rates of childhood vaccination have been high and stable for many years. Mainstream proponents of vaccination realised that only a few percent of parents were strongly opposed and that there were far more parents whose children were not fully vaccinated due to personal circumstances, including distance from doctors, travelling and inconvenient schedules. In this context, the most promising way to increase vaccination rates was to make it easier for parents who supported vaccination to have their children receive all their vaccines. These proponents argued for having respectful conversations with parents as the most productive way to increase vaccination rates.

However, other pro-vaccination campaigners — including Australia’s largest media organisation, News Corp — decided to target vaccine-critical groups and to get the government to remove welfare benefits from families whose children were not fully vaccinated. This campaign succeeded in stigmatising critics and increasing financial penalties but had little or no impact on vaccination rates. In this instance, resistance to vaccination was the rationale for financial penalties. It might be said that vaccine resistance became a political tool.

How should we think about resistance to vaccination?

If we think of slavery or the Nazis, it seems obvious that resistance is warranted, indeed praiseworthy. The same applies when resistance is to something that nearly everyone agrees is unjust or oppressive.

In the case of vaccination, the rights and wrongs of resistance are highly contested. From the point of view of supporters of vaccination, resistance is wrong: it is dangerous to public health. Furthermore, to publicly criticise vaccination is wrong because it may encourage refusal. Because vaccine hesitancy is such a danger, censorship and coercive measures are justified.

From the point of view of prominent critics of vaccination, resistance is valiant. They are campaigning for the right to choose, and pointing out information, unmentioned in official pronouncements, that they believe needs to be taken into account. Then there are parents, in particular those who want to learn enough to make their own informed decisions about their children’s health. Some of them decide to deviate from official recommendations. They become resisters.

Studying an issue like vaccination means being catapulted into a scientific controversy, a typical one in which most of the experts and groups with money and power are on one side and a few dissident experts and citizen groups are on the other. It’s possible to adopt a non-partisan position and just examine the methods of resistance, but more common is to decide one side is right and try to figure out how to help it overcome resistance. This is the path taken in numerous studies by supporters of vaccination.

The vaccination issue highlights the importance of the tactic of devaluation. Proponents stigmatise those who have reservations, calling them “anti-vaxxers.” Devaluation happens to resisters in a wide range of domains but is especially important in relation to vaccination, where the language of stigma has been taken up by many members of the public. In studying resistance, it is important to study the techniques used by authorities to subjugate resisters.

Note also that some critics put down those who are vaccinated as dupes or sheep, and send abuse and make threats against proponents. This is usually counterproductive.

Finally, it is important to note the enormous emphasis on vaccination as the solution to the problem of infectious disease and the consequent marginalisation of other methods of improving health, including exercise, good diet, sleep and avoidance of toxins. In a sense, the vaccination debate is a distraction: the focus should be on ways to protect and improve health. By putting so much attention on vaccination, and stigmatising and attacking critics, other contributors to ill-health are neglected. This includes cars and labour-saving devices that discourage physical activity, unhealthy foods, and the myriad chemicals that contaminate the environment. Companies that make great amounts of money from the way society is organised — from tech companies to town planners — avoid responsibility for associated harms. They are let off the hook by the focus on vaccination. The implication is to pay attention to issues that may be sidelined by the most prominent struggles.

The takeaway message is that the vaccination issue, including resistance, is not as simple and straightforward as often assumed. Learning more reveals complexities as well as insights for understanding resistance.

Covid vaccination: why is there resistance?

With the advent of the Covid-19 pandemic, governments introduced extraordinary measures to control the spread of the disease, including isolation orders, lockdowns, travel restrictions, contact tracing, testing, quarantining, distancing and mask-wearing. These were seen as temporary measures until Covid was brought under control. The hoped-for salvation was widespread vaccination.

            Vaccines became available in record time. But that was not the end of the story. As in the case of other vaccines, there was resistance. The story of Covid-vaccine resistance repeats what happened with many earlier vaccines. But there are also important differences.

First, the similarities. Covid vaccines promise a benefit to individuals, reducing their susceptibility to disease and to serious impacts, and also promise a collective benefit because the infectious agent, the coronavirus SARS-CoV-2, has fewer people susceptible to infection. The argument for vaccination appeals both to self-interest, to protect your own health, and to social responsibility, to protect others.

As in the case of other vaccines, there have been critical voices, including among doctors and scientists, raising the same sorts of concerns, specifically that the benefits of the vaccines are oversold and that the risks are greater than acknowledged. As in the case of other vaccines, critics and vaccine-hesitant individuals have been stigmatised.

Thus in many ways the controversy over Covid vaccines is nothing new. It raises many of the same issues familiar to those involved in the politics of vaccination. But there are also quite a few differences that have made the issue far greater than anything before.

What’s different about Covid vaccines?

First, Covid vaccines have been introduced in the middle of a pandemic, furthermore one in a world interconnected as never before. The stakes are higher. The enormous alarm about Covid has meant that hopes and fears about vaccines have a correspondingly higher profile.

Second, the benefits and risks from Covid vaccines have an unusual profile. As is well known, the benefits from Covid vaccines are greatest for those most vulnerable, namely those who are old and have other health problems. This is like the pattern for influenza, except the flu also can be dangerous to the very young. The risks from Covid vaccines, due to adverse reactions, seem to be greatest for those who are young. So for children and young people, there is a curious combination of low personal benefit and higher personal risk. Adding to this, most studies show that having Covid gives longer-lasting immunity than being vaccinated, so for those young people with the lowest risk of contracting Covid, there seems to be less to gain from vaccination.

Third, Covid vaccines are the first ones imposed on the entire adult population. Most other vaccines are given in childhood. In the United States, flu vaccines are recommended throughout life but are widely recognised as being only partly effective, and are compulsory only for a few occupations such as healthcare. In the history of vaccination, compulsion is often met with widespread opposition, which is why most health policy leaders have advised against mandatory vaccination. For most adults, Covid vaccines are the first occasion in which they have experienced strong pressure to vaccinate and, in some cases, severe sanctions for not doing so.

Fourth, vaccination is seen as part of a wider package of Covid control measures, including isolation orders, lockdowns, distancing and mask-wearing. Some of the control measures, especially lockdowns, have had a severe psychological and financial impact on some individuals and sectors of the population. This has led some individuals and groups to challenge the narrative presented by political leaders that “We are all in this together,” when it is obvious that some groups are prospering while others are paying a high price. Also important are the serious psychological impacts of isolation. Although vaccination imperatives are not responsible for the effects of other Covid control measures, they can be seen as part of an apparatus of oppression, a sort of guilt by association.

            Fifth, there has been extensive censorship of viewpoints contrary to official policy. For example, some critics have had their Facebook and YouTube accounts abruptly cancelled. However, because there are many alternative channels to obtain views contrary to orthodoxy, censorship may make critics, and anyone with reservations, feel unfairly treated. It can seem like there is not a free and open discussion.

Sixth, the call to be vaccinated for the good of the community comes after decades of neoliberal policies fostering individualism, using the rhetoric of personal freedom. People are encouraged to satisfy their desires through personal consumption of goods and services rather than through building shared activities with neighbours and friends. Employers have less loyalty to employees, who in turn treat jobs as stepping stones to personal advancement. Accepting a lower salary and status to serve the public has less attraction than before. In this context, suddenly people are called upon to make sacrifices for the common good. When they feel forced to make sacrifices, for example when their income is lowered, and they see elites with special privileges, this can make some want to push back against Covid controls — including vaccination.

            Given these factors, resistance to Covid control measures is not surprising.

What to do

What are the implications? This depends to a great extent on one’s position concerning vaccination, so I will separately list some possibilities for different views.

For those who do not want to receive Covid vaccines, or who oppose mandates or coercive measures, what is the most effective way to resist? This is not easy to answer at an individual level, because people’s circumstances vary so much. At a collective level, in many countries there have been public protests with thousands of people joining marches and rallies.

It is well known that the mass media selectively report violence, so when ten thousand people protest peacefully, if ten of them break windows or clash with police, that will lead the news. This means that it is very hard to assess what is going on except by being there or talking to many who were.

            Many of those involved are new to protest. To become more effective, one step would be to contact experienced nonviolent activists and develop a campaign strategy with clear goals and a variety of methods that will communicate concerns and mobilise greater support. Would silent vigils be effective? It’s hard to know but it would be worth trying to see whether a wider cross-section of the population would feel safe to participate. Clashes with police are likely to be counterproductive. Basically, protest organisers could learn a lot from experienced nonviolent campaigners. As well as protesting against, there could also be constructive actions that show what the desired future would be like.

Now consider implications for those who support Covid vaccinations and who are critical of or hostile towards those who refuse them. It is worthwhile to clarify goals. Is the goal greater levels of vaccination, or greater levels of immunity, or better health overall?

An initial suggestion is not to be so quick to condemn those who challenge or flout pressures to vaccinate. Although some refusers may be ill-informed, some have studied the issues, spent time weighing up options, and reached a considered decision. For such individuals, condemnation is unlikely to be helpful. Engaging in respectful conversations is more likely to be productive.

Vaccination mandates and censorship of Covid views contrary to orthodoxy may harden resistance. Some people oppose compulsory measures simply because they are compulsory. Another factor is that those who feel pressured to vaccinate are more likely to seek support from others with similar concerns. The result is that vaccination resistance transitions from individual to collective forms. In a sense, mandates create the very enemy — organised opposition — they are supposed to overcome.

Another implication is that resistance is about values, not just science. Talking about “following the science” is unlikely to be convincing to those who put a great priority on personal freedom, even at the expense of their own health. Furthermore, values can shape acceptance of medical authority, so it becomes a question of which authorities to invoke, mainstream or dissident.

            Some supporters of vaccination become self-righteous, assuming they hold the one and only truth about Covid. Furthermore, if they recognise the role of values, in particular the values of individual rights versus public health, they assume their own values are superior. Presuming to hold the one and only truth and that one’s values are unquestionable is a poor basis for understanding resistance.

Some of the concerns of well-informed resisters may point to genuine issues, for example the lack of information about long-term consequences of Covid vaccines, the lack of comprehensive studies of adverse reactions, the role of vested interests and the relative neglect of preventatives and treatments, especially using nonpatentable substances such as vitamin D and ivermectin. It is possible to learn from resisters about ways to make vaccination more credible to at least some of its critics.

It may be possible to find common cause with some Covid vaccine critics. For example, agreement might be possible over non-vaccine ways to reduce the harms from Covid, such as encouraging exercise and protecting those who are most vulnerable.

When lives are at stake and some people seem to be flouting basic advice for the common good, it is tempting to attack, condemn and use coercive measures. It would be more productive to show respect, learn from critics and join together in whatever ways are possible.

Brian Martin
bmartin@uow.edu.au

Thanks to Bob Dildine, Kelly Gates, Julia LeMonde and Tom Weber for helpful comments on drafts, and to many others for stimulating discussions on vaccination issues.

Other posts and articles about Covid

On Covid protesting

Many people have protested against Covid control measures. How can their efforts be made more effective? Should they be?


Covid protest, Melbourne, 2020

After the first major Australian public protests against lockdowns, everywhere I looked there was condemnation. Media stories highlighted violent incidents and reported that right-wing extremists were involved. Many protesters were not wearing masks, so the danger of Covid transmission was emphasised. Some prominent left-wing figures criticised the protesters, siding with the police for a change.

I thought, “Not so quick.” It is standard for media reports to focus on the negative aspects of protests, especially violence. I was reminded of protests against nuclear war back in the 1980s. Opponents dismissed the protesters as uninformed and as tools of the Soviet Union. Didn’t they know nuclear weapons are there to protect us?

Here I’m going to present some ideas from research on protest movement strategy and comment about how these ideas can apply to resistance to Covid control measures. For those who oppose Covid protests, there are a few suggestions at the end.

Why would I want to suggest ways for Covid protests to be more effective? Most importantly, if people are going to protest, I think it’s better for all of us when they use nonviolent methods — whether or not you or I agree with their goals. Many of those involved are first-time protesters, and it would be good if they developed their understanding and skills. You never know when you might want them on your side.


Covid protest in France

Background

Governments around the world have responded to the Covid-19 pandemic with a variety of control measures, including distancing, quarantining, masking, lockdowns and promotion of vaccination. Many governments have used Covid as a justification for restrictions on civil liberties. In many places, there has been resistance to these measures, including massive protests.

In Australia, government leaders have condemned the protests and the protesters, while mass media have mostly ignored or condemned them. A common response is to say that control measures are to protect the public from a dangerous disease and that protesters are being irresponsible: they are threatening public health. My impression is that the same sort of response to protests occurs in many other countries.

My personal background is relevant to this issue in two ways. Since the late 1970s, I’ve been studying scientific controversies, including the ones over nuclear power, pesticides, fluoridation, the origin of AIDS — and vaccination.

Also since the late 1970s, I’ve been involved with social movements, including the movement against nuclear power and the peace movement. Related to this, I’ve studied nonviolent action, which refers to methods like rallies, strikes, boycotts and sit-ins. As well, I compiled a collection of resources for resisting repression in Australia.


Covid protest in Berlin

Covid protest rallies fit the usual model of protest: people have a grievance or a social concern and join together to express their feelings in the hope of promoting change in policies or practices. The strange thing is that so many activists from other movements seem to have stayed away, and furthermore to condemn the protesters. They hear about Covid protesters who are linked to right-wing extremists, or who have weird ideas, and dismiss the protesters as dangerous and ignorant.

Controversy

Concerning Covid, most governments and health authorities have adopted a standard view, that the pandemic is a major threat to public health warranting extreme measures to control the threat. However, the standard view has been contested by some researchers and doctors. This is a typical public scientific controversy, similar in many ways to others I have studied. There is disagreement about technical matters and the technical disagreements are mixed in with differences about ethics and decision-making.

There are actually several Covid controversies. One is over the origin of Covid: wet markets or lab leak. Others are over the seriousness of Covid, treatments for the disease, vaccination, masks and lockdowns.


Lab leak or wet market?

As with many other controversies, such as over climate change, genetic modification and fluoridation, those on the side of scientific orthodoxy say critics are ill-informed, ignorant and dangerous, and that governments and the public should trust the experts. They assume there is only one rational response and that anyone who disagrees is “anti-science.” This obscures the role of differences in values. In disputes over Covid control measures, there are differences in values placed on controlling Covid versus freedom of movement and assembly.

Here I’m going to offer some ideas about Covid protests drawn from the theory and practice of nonviolent action. These ideas are fairly general because I haven’t participated in any protests and because there is so much variation in experiences from place to place, worldwide and even within Australia. Those opposed to Covid protests can skip to my remarks in the final section.


Covid protest in London

Getting the message out

Rallies and civil disobedience are good for showing passion, commitment and breadth of concern, but they are not so good for communicating the reasons people are protesting. Media coverage, if there is any, is usually more about the events than the issues. Protesters can carry placards and banners, but these are too brief to communicate much about the evidence and arguments.

A social movement needs a communication strategy. One important aspect is self-education. Participants need to learn about the issue, including facts and arguments, and how to counter contrary viewpoints. Just because people join together on the streets doesn’t mean they have a deep understanding of the issues. This is nothing new. It has been true of many other movements.

A few members are highly knowledgeable. They know about all sorts of scientific research, about ethical arguments and much else. The challenge is for others in the movement to learn from them. In anti-war movements of yore, one technique was the teach-in, in which knowledgeable speakers would explain issues. These days, this can be done online. It’s like a classroom, with a priority on interactive learning.

The ideal, which can never be reached, is for every person at a rally to be knowledgeable enough so that they can give a good account to a journalist or an observer. This will seldom be possible, so those who have a better grasp of the issues or are more articulate need to take the lead in talking with others.

At a rally, speakers usually try to fire up the crowd with powerful rhetoric. This is good for building a sense of a common cause but not for educating the public. It is speaking to the converted. This needs to be supplemented by a strategy to reach those who are neutral or sceptical.


Door canvasser

There are various options, such as going door to door inviting conversations, holding information meetings (online or face to face) and circulating leaflets and links. This doesn’t sound exciting. It doesn’t have the emotional impact of joining a rally, but it is the foundation of any effort to change people’s views.

A crucial part of a communication strategy is to show to others that campaigners, and people with concerns, are human, ordinary people. Given the rhetoric that anyone sceptical of the official Covid line is some sort of lunatic who doesn’t care about others’ health and welfare, it is vital that campaigners come across as sensible, reasonable, considerate and, when possible, just like other people. Messages are most persuasive when the sender is similar to the receiver in age, occupation and other characteristics.

Action

Gene Sharp in his classic book The Politics of Nonviolent Action presents the “dynamics of nonviolent action,” which is a series of stages or features of nonviolent campaigns. He developed this framework by studying numerous campaigns, such as the Indian independence struggle and the US civil rights movement. It’s worth considering how Sharp’s dynamics framework applies to campaigning against Covid control measures.

Sharp calls the first stage “laying the groundwork.” It involves communicating with supporters, building organisations and networks, developing skills and preparing for action. Laying the groundwork is a vital part of any campaign, done before taking strong action. Without sufficient preparation, movements are more likely to fade away after the initial excitement.

Covid protester organisers, however, seem to have put in relatively little effort in laying the groundwork. Instead, they have gone straight to action, calling rallies before there has been time to build the capacity of the movement. This has been possible due to social media, which enables rapid mobilisation, unlike what was possible just a few decades ago. Zeynep Tufekci in her book Twitter and Tear Gas describes the problems that can arise from mobilisation with relatively little preparation, for example in Turkey and Egypt: often there is a big impact in a short time, but without the foundations of trust and decision-making processes, the movement is susceptible to pushback from authorities, and some early gains are lost, as in Egypt after the toppling of dictator Hosni Mubarak.


Cairo, 25 January 2011

Sharp’s second stage is “challenge brings repression.” When the movement takes action against authorities, this often leads to police attacks on activists, for example beatings, arrests and shootings.

In some countries, police have been heavy-handed in shutting down Covid protests. More commonly, though, protests have been tolerated with not so much repression. The reason is that, in many countries, rallies are a regular and accepted method of protest and, in Sharp’s terms, do not constitute nonviolent action. However, when gathering in public places is banned, as with lockdown rules, a public protest is indeed a challenge to authorities and may be met with harsh measures.

What sort of action is most effective?

A challenge to authorities may bring repression, but there’s a prior question: what sort of challenge is most effective? Movements around the world have used mass rallies to challenge dictatorial rulers, and because such mass events are so visually striking, they can be seen as the essence of social action. However, rallies alone are usually not enough to bring about significant change. Also needed are other methods, and there are a lot of them, ranging from vigils to strikes to alternative economic systems.

In deciding what action to take, there are several considerations. One is to enable participation by as many people as possible, from different walks of life. This builds the movement. Another consideration is to make the action as meaningful and empowering as possible for participants. This also builds the movement. Thirdly, ideally the methods used in the action should be ones compatible with the goal being sought. There are other considerations too. How will members of the public react? How will the police react? Choosing the right action is not a simple matter.


Covid protest in Italy

In the age of Covid, many people are deeply frightened of catching the disease. Therefore, when they see large crowds of people protesting, not wearing masks and not keeping distance, they are frightened. The crowds may be outside, where the risk of transmitting an infection is far less than indoors, but that doesn’t do much to reduce the fear. So what about other actions? What about a silent march, single file, wearing masks and carrying candles? This would be less threatening, many people can join in and it might be more moving for those involved.

It’s useful to think of two sorts of actions: those that resist injustice and those that help build an alternative world. Imagine a stall in which activists pass out free vitamin D capsules. Vitamin D is cheap and not patentable, and some research suggests it reduces the risk of contracting Covid. This sort of action could generate attention to alternatives to control measures.

Remaining nonviolent

There is one other vital consideration: not using violence. The third element in Sharp’s dynamics of nonviolent action is “solidarity and discipline to fight repression.” The key is to “maintain nonviolent discipline”. By this, Sharp means not using physical violence against police or other authorities. If there’s a rally of a thousand people and two of them throw bricks through shop windows and try to fight police, their behaviour can discredit the whole protest and become a pretext for police violence against the entire group.

Here’s the situation. When no one protesting uses any violence, then if police attack, it can be seen by many observers as unfair, and this can generate sympathy for the protesters. However, if any protesters use violence, this turns the engagement into a contest – a violent confrontation – and the police have all the advantages.

Experienced nonviolent campaigners try to ensure nonviolent discipline by announcing publicly that they are committed to remaining peaceful and by arranging for participants to go through some preparation beforehand so they don’t react to provocations.

In 1960 in Nashville, Tennessee, Black activists in the US civil rights movement wanted to challenge segregation and made plans to sit at lunch counters. They knew they would be attacked, so they spent months preparing, including being able to sit while whites yelled insults and police made arrests. Their preparations paid off, leading to the ending of restaurant segregation in the city.


Lunch-counter protesters attacked in Nashville, 1960

For many Covid protests, there is no preparation at all. People show up with no experience. It’s amazing that so many rallies have been completely peaceful. Preparation would help to reduce the risk of being discredited due to the violence of a few.

Even yelling abuse at the police or politicians can be counterproductive. Being aggressive in any way signals to observers that the protesters are unruly, inconsiderate, even dangerous. Furthermore, it scares away potential participants, for example ones with children.

Then there are opponents of Covid measures who send abuse to prominent figures such as Anthony Fauci. Some send death threats. This is disastrously counterproductive. These opponents sound tough but in practice serve to alienate potential supporters.

Sensible campaigners should publicly condemn abuse and threats targeted against those on the other side, and exclude anyone who they know uses abuse and threats. If there’s one thing that will discredit a movement, especially one with fewer numbers, it’s being abusive and threatening.

When movements start to become strong, and remain nonviolent, one thing police often do is use agents, who pretend to be activists, to encourage the use of violence. There was one incident in Australia, in 2016, in which pro-vaccination campaigners apparently tried to fake Twitter messages to appear like abuse from vaccine critics.

This all ties in with Sharp’s next stage, political jiu-jitsu. When police attack peaceful protesters — ones who maintain nonviolent discipline in spite of provocations — this can often lead to greater support for the movement. There are famous instances, for example in India in 1930, South Africa in 1960, East Timor in 1991. A similar process occurred in 2020 with the murder of George Floyd, triggering a massive expansion of the Black Lives Matter movement. This process of political jiu-jitsu can be observed, on a small scale, in the mobilising impact of videos showing police abusing Covid protesters.

Aftermath of Sharpeville massacre, South Africa, 1960

However, police brutality doesn’t always lead to political jiu-jitsu. Police have regular ways of reducing public outrage. Activists need to learn how to counter police tactics of outrage management.

There are more stages in Sharp’s dynamics and more I could say about making campaigns effective, but this is enough for now. There is a lot of writing about how to build social movements, including Bill Moyer’s Movement Action Plan and Mark and Paul Engler’s book This Is an Uprising. There are many experienced nonviolent activists in a range of movements, for example climate campaigners. My advice would be to make contact with experienced activists, get their advice and learn from them. Some may not be willing to help Covid protesters, but some will. Some may be sympathetic to protest goals, and some may think, “I don’t agree with your goals but if you’re going to protest it’s better to do it following nonviolence principles.”

One last point: prepare for a long struggle. When people first join a rally or a protest group, they come with enthusiasm that success is not far away. After all, they know they have justice on their side and all that’s needed is to help others to see the truth. This isn’t the way it works. Your truths may be heresy to others. Many campaigns go on for decades. Think of nuclear power, fluoridation, animal rights and climate change. Covid struggles might be with us for a very long time. Maybe not, but it’s better to prepare for a long struggle, indeed for one in which things get worse before they get better.


Covid protest, Washington state, USA

The other side

What if you think Covid protesters are deluded and dangerous? What’s the best way to respond?

  1. Discourage attacks. Every time police are heavy-handed with a protester, there’s a chance of turning the protester into a martyr. Remember political jiu-jitsu.
  2. Oppose mandates, such as vaccination mandates, and coercive measures. These are likely to foster greater resentment and resistance.
  3. Encourage responsible protest. If people are going to protest, it’s better if they do so with less risk to public health and less danger to police and bystanders.
  4. Engage in respectful conversations with people who have contrary views. Learn about their concerns and suggest ways forward.
  5. Search for common interests. Most people are concerned about wellbeing but they may have different ideas about how to achieve it. For example, it may be possible to agree on encouraging exercise, which can improve health and the immune system, even while disagreeing about lockdowns or vaccinations.


Running protest against racial injustice, USA

These methods won’t end the divisions and the conflict, but at least they won’t make things worse. Remember, Covid conflicts may be with us for a long time, so it’s worth finding ways to manage the conflict that bring out the better side of human nature.

Brian Martin
bmartin@uow.edu.au

For valuable comments, thanks to Paula Arvela, Anneleis Humphries, Julia LeMonde, Monika Onken and others who prefer not to be named.

Other posts and articles about Covid

Making a vaccine in record time

Did you ever wonder how Covid-19 vaccines were developed so quickly? Usually it takes five or ten years to develop and approve a new vaccine, but in 2020 several vaccines were ready in less than a year. This speed led to suspicions about quality and safety being compromised.


Sarah Gilbert

     For an explanation, turn to the new book Vaxxers by Sarah Gilbert and Catherine Green. They are key members of the team at Oxford University that developed the AstraZeneca vaccine. Vaxxers is an engaging first-hand account that contains many insights.

Gilbert and Green had been working on vaccine development for a great many years. They and their collaborators sought ways to prevent diseases such as Ebola, malaria and MERS. One of their accomplishments was development of a vaccine platform, a cell structure that could be used to enable new vaccines to be created very quickly.

People sometimes say, “Why wasn’t anyone preparing for a new pandemic?” Gilbert and Green say, with some exasperation, that is exactly what they were doing. The trouble was that they found it exceedingly difficult to obtain funds to make better preparations.


Catherine Green

Nonetheless, when Covid arrived on the scene, they were far better prepared than they might have been. The initial challenge was to recognise that the first reports of a new infectious disease in Wuhan, China, represented an urgent priority. Gilbert and Green had other projects under way, and a variety of personal and professional commitments. They started monitoring the reports of the new disease. It took some time before they decided to act. When they did, progress was rapid. As soon as they obtained the genetic structure of the new coronavirus, later named SARS-CoV-2, they used their platform to create a vaccine.

“This meant that before we even knew the pathogen’s genome, we knew the design for our vaccine — the gene coding for the SARS-CoV-2 spike protein, plugged into ChAdOx1 — and once we did receive the genome, we were able to design the exact DNA sequence we needed within forty-eight hours. Less than four months after that we had the first doses made, quality-assured, and ready to use in clinical trials.” (pp. 153–154)

They make it sound easy!

As it became clear that the new disease, called Covid-19, would require full attention, they gradually mothballed their other projects and put their full energy on developing and testing a vaccine for Covid. Having a small quantity of a vaccine was just the beginning.

A personal story

Each of the chapters of Vaxxed is told either by Gilbert or Green, giving a personal perspective labelled as Sarah or Cath. The result is in part a sort of scientific autobiography. They each tell of their personal lives, their families and difficulties, their eating habits and especially their anxieties about producing the vaccine.

They put themselves under immense pressure to do everything required to make a high-quality vaccine in record time, knowing that every day shaved from the usual development schedule could make the difference to people’s lives and also knowing that mistakes could make the whole process come unstuck. At crucial stages, such as purifying the vaccine and unblinding trial results, they were confident due to having been through the same stages with previous vaccines, but they were also on tenterhooks because so much hinged on the outcome.

Scientists spend much of their time in labs and with their colleagues, and non-scientists can have a hard time appreciating what goes on. In Vaxxed, we are offered an inside look into everyday science, though in this case undertaken at high intensity and with high stakes. Gilbert and Green show they are humans just like the rest of us, with cares, hopes, distractions and lives outside of science, and with great experience and dedication in their research roles.

It is amazing that such a story has been told so soon after the events, indeed told at all. Scientists working for governments or pharmaceutical companies would have a hard time gaining approval to write such a revealing memoir. For scientists used to writing technical papers for journals in their fields, adopting a style aimed at a general audience is no mean feat. That Vaxxed is so readable may be attributed in part to excellent editorial support. At the bottom of the title page, in small print under Gilbert and Green’s names, is “Written with Deborah Crewe.”

The Oxford lab was set up to develop vaccines, not for mass production. At a crucial time, the pharmaceutical company AstraZeneca was brought on board to collaborate with the Oxford scientists and produce the vaccine in commercial quantities. Rather than using laborious lab methods to produce dozens of doses, AZ could scale up production to millions or even billions of doses.

Unlike other companies producing Covid vaccines, AZ made the magnanimous decision to provide its vaccine at cost, namely with no profit, for the duration of the pandemic, and indefinitely for low and middle-income countries. It is far cheaper than the Pfizer or Moderna vaccines.

The media

Few scientists have a high media profile, nor do many seek media attention. University administrators now encourage scientists to showcase their research, providing support from professional units that help write media releases. Gilbert and Green had been working for many years with this sort of limited interaction with journalists. Vaccines for diseases in foreign countries are seldom newsworthy. With the pandemic, suddenly there was intense interest in vaccine development for a disease affecting people in their daily lives.

Gilbert and Green tell about their steep learning curve doing media interviews, for example learning that an off-the-cuff comment, taken out of context, could become a misleading headline. They were pleased that so much coverage was supportive but then upset when a routine occurrence — pausing the trial while an adverse event was investigated — was misinterpreted and blown out of proportion. Before long, they referred all enquiries to the university’s media unit, as it was impossible to handle all requests and to do so would have meant slowing their work on the vaccine.

Gilbert and Green sometimes had to push back against media intrusions, especially when film crews in the lab caused work to be compromised. On the other hand, they appreciated the opportunity, provided by the media, to publicise the vaccine and, more generally, to enable them to get out messages they thought were important.

Lab life under a media microscope

Quite separately from its contribution to understanding vaccine development, Vaxxers is a valuable contribution to writing by scientists about their own work. The classic book in this genre is James Watson’s book The Double Helix, his account of unravelling the structure of DNA, an account criticised for male chauvinism, in particular downgrading the role of Rosalind Franklin. Vaxxers, in contrast, is written by two women scientists who explicitly deny being pathbreakers or heroes. They repeatedly acknowledge the others in their team and explain how their work on the vaccine built on years of prior work and experience. They worked extraordinarily hard not so they would be recognised as elite scientists but because they wanted to do what they could to save lives.

“Before 2020, no one had ever developed a vaccine in a year. But that was not because it could not be done. It was because it had never been tried. We were able to go faster in 2020 not because we cut any corners or took risks with our product. We still did every single thing that needed to be done to develop a vaccine safely. We did not miss out any steps. Nor was any individual task — filling a vial, vaccinating a volunteer, analysing a graph — done with less than the usual care and attention. We went faster because we had to this time — the world needed the vaccine as soon as possible and, as we know from seeing the daily death rates, every day counts.” (pp. 160–161)

Vaxxers is also different from most books in the first-person scientist memoir genre in consciously being an intervention into the debates surrounding the research. Gilbert and Green are acutely aware of concerns about the safety of Covid vaccines developed at such great speed and want to explain how they were able to move so quickly without compromising quality or safety. In this they have undoubtedly succeeded. What they cannot do, of course, is to provide the same sort of reassurance about other Covid vaccines. We can read Vaxxers but no equivalent story written by government or pharmaceutical company insiders is ever likely to be published.

While Vaxxers addresses some of the concerns about Covid vaccines, it cannot deal with all of them. The full story of the health effects of the vaccine remains to be told, as does the comparison between risks from vaccines and Covid itself, for different demographics. Nor is the story over, because new variants of Covid continue to appear, meaning that new versions of vaccines may be developed.

The only time Gilbert and Green’s treatment loses authenticity is when they write about vaccine hesitancy, about which they rely more on others’ treatments than their own research and experience. For example, Gilbert writes, “I don’t understand anti-vaxxers” (p. 192). This is understandable given that she’s not a social scientist who has spent years interviewing parents and trying to learn about vaccine hesitancy.

Regarding blood clots from the vaccine, Gilbert makes a comparison with the risk of blood clots from having Covid or from taking the contraceptive pill. This is reasonable on the surface, but Gilbert is not an expert on the science and politics of risk assessment, about which there is a vast body of research addressing complexities and value judgements.

Final comments

Supporters of vaccines can learn from Vaxxers about how the substance injected into their arms was developed. Critics of vaccines can learn this too. All their criticisms will not be answered, but at least they can be better informed.

Gilbert and Green worked exceedingly hard and long for many months, and desperately needed a break. They write about what they will do after Covid priorities recede. It’s good they decided to take the time to write Vaxxers.


Sarah Gilbert with the Barbie doll modelled on her

Brian Martin
bmartin@uow.edu.au

Disclosure: I had the AstraZeneca vaccine — hence my special interest in Vaxxers — and had no side effects.

Brian’s posts and articles about Covid

Comments from Robyn Gardner

Your review of Gilbert and Green’s work seems very balanced to me. My only reservation concerns the rush to autobiographical disclosure by scientists, which seems so common now in all fields, in government, media and the military. The speed of publication indicates that at some point it becomes part of the potential framework of research or design in any career-sensitive lab. The ‘confession’ is a kind of promotional agency, akin in some ways to pharmaceuticals’ harnessing of patient groups/parents/human interest stories for their own profits. The result is an erosion of the integrity we may imagine of/in science, pre-empting and incorporating the earlier systems of external critique and history of science.

It seems to me that popularizing and personalizing of research via the highly marketable and more inclusive representation of women is as risky in its way as the effacing of women  earlier was, which was, let’s face it, probably no different or inexorable as the effacing of many, many men – there being more men, in earlier periods, so that women may actually have had more ease of access, if only by dint of a family connection or their exception.

We still await some highly nuanced outside assessments of this cultural history and the very problematic politics of vaccine production, something akin to David Oshinsky’s Polio: An American Story which examines  the wider cultural context of a pandemic. Oshinsky’s book addresses the ‘boosters’ and marketeers of that first wave of public image harnessing as well as the personal volatile histories of Salk and Sabin. Furthermore, it addresses the upscaling of vaccine production by the moves from research and laboratory science to outsourced not-for-profit production (by the same agencies as for-profit ones or harnessed with them)  through the process of ‘gifting’ to middle tier as well as third world countries. Then there’s the old story of poorer places being used for testing in an era when you can’t as easily inject into the bodies of the disabled or the ‘isolated’ cultures of poor countries – unless you redefine them loudly and publicly as ‘most vulnerable’ and needing to be ‘included’.

We rapidly approach the place in which we are all included – so where precisely is the control group, of the unvaccinated? And what, historically, does this serve to cover over, if we’ve all been injected with so many and variable (including simian viral) and DNA active or lipid adjuvant substances, and what levels of biosecurity can possibly pertain given the places and speed of outsourcing in manufacture?


Robyn Gardner

I think of the silencing, and self-silencing, of any possible response, and of the wholesale ‘turn away’ from the polio vaccine origin-of-AIDS thesis by even those scientists who found it highly plausible, and on the part of  those who  could have been and should have been most active in inquiry. 

My concern about AstraZeneca is not the reporting of side effects in the short term, but the widely mediated hijacking of this possibility by labs and agencies and ghost-written preprints focussing on the ‘rare’ clotting events of the disease itself. The possibility of long term and highly likely slower vascular changes, not reversible, but activated – a ‘forever’ event – in vaccinated subjects will tend to get deluged and overwritten, buried, by the usual facile response of Covid causing the same or greater risk. So it goes. I guess this is science and business as usual, and the post-war scepticism about biological research, and rise of ethics, is now in reversal. We are all in thrall again to something called ‘the science’ – which is seen as pure again, and all inclusive, whilst any postgraduate qualification in the human sciences, which might include historical awareness and critical thinking, if not always clear, will cost a leg and an arm.

On not making up your mind

I’m finding it extremely difficult to remain open to a range of possibilities. On Covid in particular.

            I’ve read a large number of articles about Covid and talked with lots of people. There are articles about the urgent need for vaccinations and others about the risks of adverse reactions. There are articles about lockdowns and wearing masks, with different viewpoints. There are articles about the origin of Covid, some saying it came from wet markets and others saying it was from a lab leak.

When I read a well-documented and well-argued analysis, I think, “That’s persuasive.” Then I read another from a different perspective and think, “That sounds persuasive too.”

            Some time after the beginning of the pandemic, I decided to try to remain open to different views rather than reaching a firm conclusion. For example, there are claims for and against using ivermectin as a prophylactic, to reduce the risk of getting Covid. I don’t want to decide definitively one way or the other, at least not yet.

The trouble with reaching a firm conclusion is being trapped by confirmation bias. If I decide that mask rules are right or wrong, then I am likely to pay attention to material that supports my belief and to dismiss contrary information. I might find myself in an echo chamber.

This doesn’t mean I can’t make decisions. As soon as the AstraZeneca vaccine became available, I had my shots. That was a personal choice. But since then I’ve tried to remain open to information about the hazards of vaccines, for example from a rare blood clotting condition. Maybe it’s more common than official figures indicate.

            You see, I’m a social scientist, and I’ve studied numerous public scientific controversies, including ones over nuclear power, pesticides, fluoridation and the origin of AIDS. On some of these issues I have a strong personal view but on others I don’t. For social analysis, it sometimes can be helpful not to care strongly about the topic under investigation, as this enables looking at the dynamics of the controversy from a less emotional perspective.

A decade ago, I started studying the vaccination debate. For me, vaccination was not a personal issue, having no children and no particular problem with vaccines; I’ve had the flu vaccine for the past five years. My angle was to support free speech for vaccine critics, because I believe free and open discussion of contentious issues is better than trying to silence contrary views.

            Being open to different perspectives on vaccination was like a warm-up for being open to different Covid viewpoints. Dominant perspectives are presented by the World Health Organisation and the Centers for Disease Control and Prevention as well as by various governments and health authorities. The mainstream media mostly report the views of authorities. But then there are contrary views, some of them supported by a few doctors and researchers, readily available on social media. By subscribing to newsfeeds giving different perspectives, the volume of commentary soon becomes overwhelming. Even to try to understand the subtleties of a single issue, for example hydroxychloroquine, becomes a bottomless pit of claim and counter-claim.

Sometimes official recommendations change, for example on mask-wearing. That should encourage remaining open to different views, because you never know when a dissident view might suddenly become the orthodoxy. What I’ve learned through my studies of scientific controversies, though, is that many people, especially campaigners, adopt a view and stick with it regardless of new evidence.

            A neighbour told me that her young daughter was in hospital with a mysterious illness. It developed shortly after a routine childhood vaccination, but her doctors were adamant that the illness was not connected with vaccines. My neighbour wasn’t sure. I thought, how can the doctors be so sure? Why couldn’t they be open to the possibility, however slim, of an adverse reaction? Thankfully, her daughter recovered.

I’ve talked with colleagues who are passionately pro-vaccination and condemn anyone who is hesitant as misinformed or worse. These colleagues do not work in any field related to health, so I think, “How can they be so sure?” Are they confident because their view is the same as that of health authorities?

I’ve also talked with passionate critics of vaccination orthodoxy. Some of them have studied the issues extensively but others less so. How can they be so sure? Doesn’t anyone have doubts about what they believe?

            Trying to keep an open mind has been challenging, especially when talking with others who have strong views and think anyone who disagrees is foolish or even dangerous. It seems everyone has an opinion, even those who know little about the issues. Am I being foolish by trying to remain open to different ideas?

Some views seem so extreme or peculiar that I tend to dismiss them out of hand. Some of the claims in the “Plandemic” videos seem implausible to me. But I haven’t studied the topic in depth, so should I be confident about my judgement? Perhaps I can just ignore Plandemic claims, assigning them a tiny probability, at least until more people start taking them seriously.

            Ah, here’s a clue. When others take an idea seriously, it’s tempting to go along with them. This is influence via what is called social proof. Anyone trying to be a rigorous thinker presumably should be alert to this influence and attempt to counter it, or at least to examine the evidence used to support the idea. But this leads back to the beginning. It’s impossible to investigate all the evidence on all facets of Covid, or indeed any other controversial topic.

As I’ve persisted in trying to remain open about Covid issues, while still making decisions, I’ve noticed something else. On other issues, especially ones I haven’t studied in depth, I’m more likely to question my views. Will this lead to a state of precarious uncertainty? Or will it be a refreshing and invigorating alternative to the usual rush to judgement?

For helpful suggestions and thoughtful comments, thanks to Tonya Agostini, Paula Arvela, Kathy Flynn, Suzzanne Gray, Julia LeMonde, Monica O’Dwyer, Dalilah Shemia-Goeke, Jody Watts and Qinqing Xu.

Brian Martin
bmartin@uow.edu.au

Brian’s posts and articles about Covid

Why you should get moving

Physical activity is good for you in lots of ways, so why do so many people not get enough?

The evidence is overwhelming: exercise is good for you. Not just physically, but also mentally. Exercise reduces depression and anxiety. It boosts your memory. It protects against disease.

I’ve just read a new book, Move! by Caroline Williams, that tells about some of the latest research on the benefits of physical activity. More on that in a moment. First, a few observations.

Working in universities for many decades, I’ve met numerous smart people, including some who think highly of their own intellects. After all, one of the few talents that academics have more than others is using their minds to extend knowledge. Yet if academics are proud of their mental capacities, and seek advancement in their careers depending on the outputs from their intellectual prowess, why do so few take heed of the evidence that physical activity protects the mind and boosts mental performance?

            There are several possible explanations. One is a persistent belief that the mind is pretty much independent of the body. Another is that using your body is lower in status than mental work. This is why, if you’re going to exercise vigorously, do it in a gym where you have to pay, not out in public. Driving a car is more dignified than walking to work.

A third explanation is that our lifestyles are designed to discourage exercise. More on that later.

Move!

Caroline Williams is a science writer. She interviewed scientists researching how the body affects the mind, and weaves what she has learned into an engaging account, adding comments drawing on her own experiences. If you need convincing that movement is good for you, Move! is a good place to start.

            The book is more than a motivator. Williams tells how different sorts of movement affect different aspects of mental performance, including creativity. She starts by telling about human evolution and how movement and mental functioning are intertwined.

“… our biological baseline is to be on our feet, moving and thinking at the same time. If we don’t do it, our brains make the sensible decision to save energy by cutting brain capacity. In better news, when we get on our feet and move, it primes the brain to be alert and to learn.” (p. 32)

This reminds me of research I read about years ago saying that the brains of people over age 50 start to shrink — except for those who exercise regularly. Use your body or lose your mind.

Williams reports on research about physical activity and rumination, which is repeatedly and unproductively thinking about things in the past. The more you ruminate, the less happy you’ll be. Here’s a surprising finding. When you are moving, walking or jogging, you are literally putting things behind you, and this sense of forward movement reduces rumination and hence is good for your mental health. This made me wonder whether walking outdoors is superior to walking on a treadmill, because with a treadmill you remain in the same place. Maybe you still feel you’re moving forward, especially if you watch a screen showing scenery going by.

            As well as moving, it’s also valuable to build your strength. Having stronger muscles leads to a longer life and makes you feel better too. You don’t need a physique like Arnold Schwartzenegger’s: you can be stronger without any increase in muscle size. There are mental benefits too. Williams states:

“There is also a link between bodily strength and a healthy brain. A ten-year study of twins showed that greater strength in middle age is linked not only to more grey matter but also to a better functioning memory and a quicker brain a decade later, while grip strength (an overall indicator of muscle power) is associated with a healthier hippocampus.” (p. 57)

Many people think muscle-builders are less intelligent than weedy types who spend their days reading. This needs to change. Having strong muscles and flexing them regularly is a good way to enhance brain power and creativity.

To get moving is good. To do it in rhythm is even better, certainly for mental functioning. Dancing is one option. Another is an exercise class, accompanied by energising music.

            Moving together with others dissolves the sense of self, so you feel part of the group. Williams notes that you need to be careful about this. The Nazi salute and mass rallies helped to bond the German population with Hitler.

“Sit up straight!” Did your parents ever tell you this? Slouching may feel more comfortable, but there’s solid scientific evidence about the physical and mental benefits of good posture. Sitting or standing straight is linked to having positive thoughts. More generally, using core muscles is good for controlling stress. Options include running, Pilates and yoga. Strangely, using core muscles is calming.

            Stretching is good for you too. If you’ve been sitting for a while, it’s beneficial to get up and stretch. Williams delves into the advantages and disadvantages of stretching beyond what the mind says is too far, and the challenges for those who have hyper-mobile joints.

Then there is breathing, normally an automatic activity but one that can be the focus of attention. Williams tells of research on breathing six times per minute, a process that stimulates the vagus nerve and calms the body.

Barriers to physical activity

Given decades of research showing the physical and mental benefits of physical activity, you might think that everyone would be going out of their way to keep active. Alas, only a minority do, and those who are older and need it the most are the least likely to move enough for optimal mental and physical health. Why?

The main problem is that humans have constructed environments for themselves that make it too easy to be lethargic, at all ages. Think of “labour-saving” devices. Think of cars, ride-on mowers, video games, Facebook. Think of parents protecting their children by driving them to school.

In the book The Energy Glut, Ian Roberts says cycling to work is dangerous but it’s even more dangerous not to cycle to work. In other words, the health risks from not getting exercise are greater than those from commuting by bicycle.

            In Australia and many other countries, cities are constructed in ways that discourage everyday walking and cycling. There are vast car parks around shopping centres and just a few places for bicycles. Imagine an alternative urban design, closer to that in Amsterdam, that makes it easy and attractive to walk and cycle, and makes it slow and inconvenient for drivers.

Unfortunately, most of us live in what is called an obesogenic environment, one that discourages activity and encourages overeating. Although it’s possible to go to the gym or participate in sports, the trouble is that this requires initiative. A society that prioritises movement would design the physical environment and incentives so that being active would be the easy option and sitting for hours on end was considered foolish.

We can dream about an alternative society, but until things change it is mostly up to individuals to do what they can in their personal situations. So read Move! and be inspired. And while you’re reading it, remember to occasionally get up and stretch.


Caroline Williams

PS Some earlier accounts that I’ve found useful.

John Ratey with Eric Hagerman, Spark: The Revolutionary New Science of Exercise and the Brain (New York: Little, Brown, 2008)

Ralph S. Paffenbarger, Jr. and Eric Olsen, LifeFit: An Effective Exercise Program for Optimal Health and a Longer Life (Champaign, IL: Human Kinetics, 1996)

Roy J. Shephard, Aging, Physical Activity, and Health (Champaign, IL: Human Kinetics, 1997)

Thanks to Tonya Agostini, Julia LeMonde, Monica O’Dwyer, Tim Johnson-Newell and Jody Watts for helpful comments.

Brian Martin
bmartin@uow.edu.au

The virus and the economy

The coronavirus pandemic highlights fundamental shortcomings in the way the economic system is set up.

What is the best way to respond to covid-19? There is commonly assumed to be a trade-off between lives and the economy: precautions and controls are needed to save lives but they cause damage to the economy.

There’s an unstated assumption in this thinking, namely that “the economy” is vital to people’s wellbeing. This needs to be questioned. It has been long known that the Gross Domestic Product or GDP is not an accurate reflection of people’s wellbeing. GDP is boosted by negatives such as traffic accidents, environmental destruction and ill health.

A deeper problem is that people’s happiness levels are not very sensitive to increases in average income, at least above some basic level. Happiness depends more strongly on things like close personal relationships, having a purpose in life, physical activity, expressing gratitude and helping others. In countries with a high GDP per capita, average happiness levels have been mostly stable for decades despite continuing economic growth.

            Another problem is inequality. GDP per capita might be high but hide inequality: the average income might be rising but mainly to benefit the top 10% or top 1%. The more unequal the distribution of income and wealth in a country, the worse off it is in lots of ways, such as more illness, crime and mental disorders.

The economic system

Pandemic control measures have highlighted the problem of thinking of the economy as a universally beneficial entity that needs to be protected and enhanced. The economic system is better understood as a particular way of organising two things: production and distribution.

First think of the production of goods and services, which involves people, skills and technology. Food production, for example, involves growing and harvesting crops and getting them to consumers. We see the results of production around us all the time: streets, hairdressers, schools and mobile devices.


Do you deserve to own a luxury villa?

The second part of the system is distribution, which refers to who gets what. Some people have palatial homes; others are homeless. Some people have access to expensive entertainment; others do not. The assumption underlying the distribution system is that it is based on merit in some way, so those who contribute the most receive the most. This assumption is deeply flawed.

Suppose you were born with a serious brain impairment and your parents abandon you. It will be pretty difficult for you to learn to read and write, much less obtain a high-level job. Do you deserve less than someone born unimpaired into a wealthy family?


Do you deserve to be homeless?

            You may feel that you’ve worked very hard in your life, so you deserve a good salary. But what about someone who worked just as hard but had a bit of bad luck and ended up in an also-ran category? The difference between a sports star and one who didn’t make the grade may be a matter of a few seconds in a race or being injury-free or getting a lucky break. The difference between a CEO and lower-level manager may be only a matter of who you know or of having just the right style and conformity to rise in the organisational hierarchy. The role of luck in success is often neglected.

The way the economic system distributes goods and services to people depends on a whole range of arbitrary arrangements, including laws on inheritance, occupational barriers, and the sorts of employment that receive compensation. Being a parent is usually unpaid, yet it is vital to the operation of the system.

The coronavirus pandemic has highlighted the arbitrariness of the distribution system. Entire industries, such as tourism and hospitality, have been devastated. The idea that workers get what they deserve is shown up as misguided. It was misguided before, but now this is more obvious.

Universal basic income?

What is the alternative? One option is a guaranteed annual income, also known as a universal basic income or UBI. Everyone, from newborns to the elderly, would receive a regular income, no strings attached. Anything earned would be in addition.

            Many people respond to the idea of a UBI with a series of objections. How will it be paid for? Who will do the undesirable jobs? Won’t lots of people just decide not to work? There’s a body of research and writing addressing such objections. The calculations about how to pay for a UBI have been carried out. If no one wants to do undesirable jobs, then increase wages. There have been experiments showing that when poor people are given cash, nearly all use it “responsibly.”

The objection that people can’t be trusted to use money responsibly is always used against the poor, not the rich. If people can’t be trusted receiving money they didn’t work for, then inheritance should be abolished. After all, someone inheriting a lot of money can’t be trusted to use it responsibly.

The other side of the UBI issue is its benefits. Millions of workers would be liberated — if they so wished — from what David Graeber calls “bullshit jobs.” These are jobs that benefit no one and could be gotten rid of with no loss of productivity.

            Decades ago, J. W. Smith wrote The World’s Wasted Wealth, documenting the massive amount of production in excess of needs in industrial and post-industrial societies. Smith showed that a large percentage of work in many occupations serves only to redistribute wealth to those occupations, with case studies of insurance, law, transport, agriculture, medicine and welfare. Smith also argued that property rights, by being too great, take wealth from the community, with case studies of land, finance capital, intellectual property and communications. His overall conclusion is that organisation of society is highly wasteful and destructive, all to ensure that privileged groups retain their privilege.

            Work is a vital part of many people’s lives. It gives meaning, provides a connection to others and, bullshit jobs aside, provides some satisfaction for contributing to society. There’s evidence that people gladly accept lower pay if their work helps those with the greatest need. Indeed, research shows that helping other people is a powerful way of increasing happiness.

A UBI would also address the curse of the contemporary economy, job insecurity. In the economic approach called neoliberalism, workers are treated as free agents who have to sell themselves to employers, without guarantees of security. This is supposed to boost “the economy” but sacrifices the wellbeing of a large number of the people who are supposed to be served by the economy.

Job insecurity contributes to the spread of the coronavirus when people who have disease symptoms feel they must show up for their jobs to survive. A UBI would reduce the incentive to work while ill and thus save lives.

Industrial and post-industrial societies have an enormous productive capacity, far greater than necessary to provide necessities to every individual and to provide extra support for those who need it the most. Yet these societies are stuck in economic arrangements that assume scarcity, protect and reward the wealthy and stigmatise the poor and marginalised. Logically, it would make much more sense to celebrate abundance and spread it around. In part, this can be done by expanding the commons, those resources that are available to all. In part, it can be done by designing work around the needs of people rather than fitting people into slots in “the economy.”

What level for society?

In their pioneering book The Spirit Level, Richard Wilkinson and Kate Pickett gathered a range of evidence about the links between economic inequality and the quality of life. They found a remarkable consistency in these links: in just about every way, inequality was associated with bad outcomes for people. When societies are more unequal in income and wealth, they are likely to have more crime, shorter life spans, higher prison populations, more mental illness, worse health and poorer educational performance.

           It is important to note that inequality is not the sole causative factor. For example, a range of socio-cultural factors can affect people’s wellbeing.

A decade later, Wilkinson and Pickett wrote another book, The Inner Level, in which they canvass a wide range of research on the ways that inequality affects people’s behaviour and thinking. Inequality, they argue, makes people more status-sensitive, fosters materialism and makes relationships more difficult. Wilkinson and Pickett write,

“The reality is that inequality causes real suffering, regardless of how we choose to label such distress. Greater inequality heightens social threat and status anxiety, evoking feelings of shame which feed into our instincts for withdrawal, submission and subordination: when the social pyramid gets higher and steeper and status insecurity increases, there are widespread psychological costs. Status competition and anxiety increase, people become less friendly, less altruistic and more likely to put others down.” (p. 56).

Wilkinson and Pickett say that inequality leads to pressure to present yourself to others in a flattering light. It leads to more narcissism, more business psychopaths, less empathy and altruism. Yet there is some hope. Studies show that when rich people think about egalitarian values, they become more ethical. Wilkinson and Pickett cite surveys showing most people would prefer their societies to be more equal economically.

Research on inequality suggests that everyone, including the rich, would be better off if societies were more equal, yet the driving forces pushing for ever greater economic inequality seem relentless, at least since the rise of neoliberalism in the 1980s. How to help counter these forces is a great unanswered question. Suffice it to say that groups are doing what they can to raise awareness, promote alternatives and encourage action.

            In this context, the pandemic is a wildcard. It offers an incentive for communities to pull together and make sacrifices to protect those who are most vulnerable. It sends a message that there is more to life than money and status. Indeed, life itself is at stake. Furthermore, pandemic control measures, by requiring greater distancing between people, have highlighted the importance of personal relationships in wellbeing. By forcing some people to slow down, the control measures have the potential to encourage people to reflect on their lives and priorities.

On the other hand, pandemic control measures are having some disastrous effects, increasing the risk of domestic violence and suicide, while enabling governments to justify draconian powers for surveillance and control of movement. It is possible to lapse into despair at the prospect of a terrible choice between control measures of indefinite duration and a continuing health crisis. A more positive agenda comes from looking at the way the pandemic opens the door to greater thinking of ways to improve people’s lives. It does not come from thinking of a choice between covid-19 and “the economy.” The emphasis needs to be on people’s needs, especially those that come from relationships of mutual support, meaningful work and helping others.

Brian Martin
bmartin@uow.edu.au

Thanks to Lyn Carson and Richard Eckersley for helpful comments.

This post was published in Social Medicine and (in Spanish) in Medicina Social in vol. 13, no. 2, May-August 2020.

Brian’s posts and articles about Covid

 

 

 

Vaccination debates: the corona connection

The coronavirus pandemic has intriguing connections with longstanding debates about vaccination.

Background

Vaccination proponents say it’s one of the most important public health measures of the past century, with its benefits in reducing infectious disease vastly outweighing any small risks. Critics say the benefits are overrated and that adverse effects are greater than normally acknowledged.

This was the state of play before the emergence of the new coronavirus, officially known as SARS-CoV-2. How does the coronavirus disease, Covid-19, affect the longstanding claims and counterclaims in the vaccination debate?

 

Quandaries for vaccination proponents

Covid-19 undermines one of the usual arguments for vaccination, namely that unless most people receive routine vaccinations, there is a possibility of a pandemic like the Spanish flu of 1918–1920 linked to the deaths of tens of millions of people. A moment’s reflection, though, should be enough to realise that vaccinating against polio and measles provides little or no protection against a new virus.

Vaccination proponents have tacitly admitted that, when a vaccine is not available, other measures may be necessary, notably contact tracing, quarantine and physical distancing along with hand-washing and other hygienic measures to reduce the risk of transmission. These are relevant for many vaccine-preventable diseases such as measles and whooping cough but are seldom emphasised, perhaps because they might detract from the importance, efficacy and efficiency of vaccination as the first line of defence.

Covid-19 has brought another possibility onto the agenda: the immunity to an infectious disease acquired by having it. This sort of acquired immunity was common before the advent of vaccines.

The entire population, referred to as the herd, is protected if enough people are immune. When, before the measles vaccine, most children had measles, this provided protection for those whose immune systems were impaired. If most people in a community have had Covid-19 then, assuming having had the disease confers immunity, the pandemic will end. However, this is likely to involve much illness and many deaths before herd immunity is attained.

            Critics of vaccines have argued that there are advantages to acquiring immunity by having a disease. Before Covid-19, this argument received very little public attention.

In the vaccination debate, proponents emphasise the importance of herd immunity. This is taken to be vaccine-induced herd immunity. That is, when most people are vaccinated and most gain immunity as a result, the disease agent dies out for lack of individuals to infect.

Some commentators (including scientists) have suggested that widespread immunity acquired from having Covid-19 is an endpoint worth considering. A possible option is to allow or even encourage young and healthy people to be infected while protecting older vulnerable individuals. Few governments have adopted this option, perhaps because it clashes with the vaccination paradigm.

In summary, Covid-19 has undercut the common assumption that vaccines are the only way of dealing with infectious diseases. Claims about unvaccinated children being a health threat, and their parents being irresponsible, have been superseded by worries about contagion from coronavirus-infected individuals.

Quandaries for vaccine critics

For critics of vaccination, Covid-19 raises a possibility that might not be welcome: that an effective vaccine, if developed, might be just what is needed to bring the pandemic under control or to limit its damage. Although all vaccines pose risks, if Covid-19 is as deadly as commonly believed, even a vaccine with significant adverse effects could have more benefits than harms. This is the same sort of assessment used with other vaccine-preventable diseases.

There has been much commentary about how long it will take to test a vaccine and roll it out for the world’s population. There is no guarantee that an effective vaccine can be developed. Just as importantly, vaccines pose risks, especially when introduced for emergency purposes. Mention has been made of the vaccine for the 1976 swine flu, a vaccine that caused more harm than the flu.

Vaccine critics are already warning about the potential dangers of a coronavirus vaccine, especially one that has not received sufficient testing. Some critics see a coronavirus vaccine as a stalking horse for the introduction of mandatory vaccination, including for other vaccines. The social control measures introduced for dealing with Covid-19 might be a precursor for a different control measure: enforced vaccination despite the risks.

Absent viewpoints

The public debate over vaccination is polarised: there are two sides with sharply divergent positions on benefits, risks, ethics and decision-making. This polarisation of the public debate occurs despite both sides having the same ultimate goal: protecting the health of the population, especially children. One of the effects of polarisation is to sideline other perspectives.

Proponents and critics of vaccination agree that immunity to disease is important but differ about the sorts of immunity they emphasise. Proponents focus on the benefits of vaccine-induced immunity whereas critics point to the benefits of natural  immunity.

The immune system can also be boosted through various means, including exercise, diet, vitamin D, sleep and mindfulness. (For references, see my book Vaccination Panic in Australia, pages 352-355.) One of the contradictory features of the response to Covid-19 is that control measures, especially quarantine, distancing and closure of businesses, may have negative effects on an individual’s immune system.

When gyms and pools are closed and exercise classes banned, people get less exercise. In principle, people can exercise by themselves at home, and indeed are encouraged to, but for many individuals the control measures will reduce their level of physical activity. Exercise has many health benefits aside from immune system improvement.

            How control measures are affecting diet is hard to determine. Closure of fast-food outlets might improve some people’s diets. On the other hand, staying at home and worrying can lead to less healthy eating.

            The body manufactures vitamin D when the skin is exposed to sunlight. Staying inside reduces vitamin D production.

Ample sleep benefits people’s immune systems and general health. Staying home more of the time may be enabling people to get more sleep, though worries and physical inactivity can impair sleep quantity and quality.

Mindfulness refers to a state of mind that is calm and focused; meditation is one way to be mindful. Worrying about Covid-19, and obsessively seeking information about risks, is contrary to mindfulness. So are losing one’s job and worrying about finances.

Research shows that personal relationships are crucially important to happiness. Distancing measures have disrupted many relationships, especially physical contact, and thus have adversely impacted wellbeing. There are also other adverse impacts, including increases in domestic violence.

            It is difficult to quantify the impacts of control measures on exercise, diet, vitamin D, sleep, mindfulness and relationships and hence difficult to take them into account in policy-making. Probably the impacts are more negative than positive.

One thing is certain: the vaccination debate will continue. Covid-19 may be causing some shifts in public discussions about immunity and vaccination but is incapable of ending the overall controversy.

Brian Martin
bmartin@uow.edu.au

Thanks to Tonya Agostini, Kevin Dew, Meryl Dorey, John Potterat, Jennifer Reich, Samantha Vanderslott and Jody Watts for valuable feedback on drafts. None of them necessarily agrees with any of the views in this post.

Brian’s posts and articles about Covid